Assessment of Postoperative Outcomes Using Half and Full Vacuum Drainage Systems in Modified Radical Mastectomy

Background: Modified radical mastectomy is commonly associated with postoperative complications such as seroma formation, prolonged drainage, and wound-related morbidity. Closed suction drainage plays an important role in reducing dead space and preventing fluid accumulation following surgery. However, the optimal level of vacuum pressure remains controversial. Half vacuum drainage may reduce tissue trauma and discomfort while maintaining adequate drainage, whereas full vacuum drainage may facilitate faster fluid evacuation but can increase postoperative pain and tissue adherence. The aim is to compare the postoperative outcomes of half vacuum and full vacuum drainage systems following modified radical mastectomy. Material and Methods: This prospective comparative study was conducted over a period of 10 months in the Department of General Surgery at Sree Mookambika Institute of Medical Sciences. A total of 55 female patients undergoing modified radical mastectomy for carcinoma breast were included in the study. Patients were divided into two groups, Group A included 28 patients managed with half vacuum suction drainage, while Group B included 27 patients managed with full vacuum suction drainage. Postoperative parameters assessed included total drain output, duration of drain placement, postoperative pain, seroma formation, wound infection, flap necrosis, duration of hospital stay, and need for seroma aspiration. Statistical analysis was performed using chi-square test and independent t-test. Results: The mean total drain output was significantly lower in the half vacuum group (468.2 ± 102.4 mL) compared to the full vacuum group (612.5 ± 128.6 mL) (p < 0.01). The duration of drain placement was shorter in Group A than in Group B (p < 0.01). Seroma formation was observed in 4 (14.3%) patients in the half vacuum group and 10 (37.0%) patients in the full vacuum group (p = 0.04). Postoperative pain scores were significantly lower in Group A. Surgical site infection occurred in 2 (7.1%) patients in Group A and 4 (14.8%) patients in Group B. The mean hospital stay was significantly shorter in Group A compared to Group B (p < 0.01). Conclusion: Half vacuum suction drainage following modified radical mastectomy was associated with reduced postoperative drainage, lower pain scores, decreased seroma formation, and shorter hospital stay compared to full vacuum drainage.

Keywords: Breast carcinoma; Drainage system; Full vacuum drainage; Modified radical mastectomy; Postoperative complications; Seroma formation; Suction drainage.