203 posters, 14 topics, 5 sessions, 817 authors, 256 institutions

The AAPS 102nd Annual Meeting

May 18-21, 2024 | The Westin Copley Place, Boston, MA

Accidental Drain Dislodgement Is Associated With Post-operative Complications After Abdominal Contouring Surgery

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Poster Presenter

Navya Baranwal

Authors

Navya Baranwal, John Slate-Romano, Sophia Ahn, Damon McIntire, Nikhil Sobti, Raman Mehrzad, Paul Liu, Rachel Sullivan

Affiliations

Warren Alpert Medical School of Brown University, Division of Plastic Surgery, Warren Alpert Medical School of Brown University

Part of Topic

Aesthetic Breast/Body Contouring

Accidental Drain Dislodgement is Associated with Post-Operative Complications after Abdominal Contouring Surgery

Navya Baranwal, BA; John Slate-Romano, MD; Sophia Ahn, BA; Damon McIntire, MD; Nikhil Sobti, MD; Raman Mehrzad, MD MHL MBA; Paul Liu, MD; Rachel Sullivan, MD

Division of Plastic Surgery, Warren Alpert Medical School of Brown University

Background:

Surgical drains are integral in post-operative management after abdominal contouring surgeries

• Remove excess fluids that accumulate in the wound bed

• Help prevent seromas, infections, and delayed wound healing
Drain removal is typically guided by specific volume criteria

• Removal when daily output < 30cc

• Some surgeons adhere to fixed-duration protocols
Lack of standardized guidelines for managing accidental drain dislodgement
Precise consequences of premature drain loss remain unknown

Objective:

To explore the relationship between accidental drain dislodgement and post-operative complications after abdominal contouring surgeries

Study Design:

Retrospective analysis of patients undergoing abdominal contouring procedures (abdominoplasty or panniculectomy)
Study Period: April 2015 – February 2023
Data Source: Electronic Medical Records
Independent Variable: premature drain dislodgement status

• Premature drain dislodgment defined as accidental drain dislodgment while output was > 30 cc/day
Outcome: Post-Operative Wound Complications

• Complications categorized by Clavien Dindo System (Grades 1-4), taking complication severity, and requirement for interventions, reoperations, and readmissions into consideration

• Hematoma, Seroma, Infection, Dehiscence, Delayed Wound Healing
Statistics: Multivariate logistical regression model to assess association between premature drain dislodgement and complications

• Adjusted for age, smoking status, diabetes, BMI, resection mass, and combined surgery

Conclusions:

Accidental drain dislodgment is associated with significantly increased wound complications after abdominal contouring surgery.

• Increased risk of complications requiring higher grade interventions (Clavien Dindo 2-4), seroma, and infection

Demonstrates importance of maintaining surgical drains until appropriate time

Plastic surgeons should be aware of potential increased risk of complications after premature drain dislodgment.

Comprehensive drain care education should be emphasized • Accurate drain output documentation
• Careful drain maneuvering
• Reporting drain dislodgment to surgeon

Limitations:

Single-institution study
Small sample size of patients with premature drain dislodgment Drain daily output was not always recorded in the charts

Future Directions:

Prospective study examining association between drain dislodgment and post- operative complications

• Have patients complete drain output log for output accuracy Improve patient drain care education

Explore additional strategies for improved drain securement, including taping and stitching techniques