Application of vacuum-assisted closure in breast cancer postoperative severe subcutaneous effusion

Abstract

Objective To study effectiveness of vacuum-assisted closure (VAC) for the treatment of breast cancer postoperative severe subcutaneous effusion. Methods From January 2012 to June 2016, a total of 57 cases patients who were diagnosed as breast cancer postoperative severe subcutaneous effusion (> 30 mL/d) in Sichuan Academy of Medical Science & Sichuan Provincial People′s Hospital (East Branch) were chosen as study subjects. According to random number table method, they were randomly divided into VAC group(n=35, treated by VAC), and control group (n=30, treated by conventional drainage). Healing time, drainage time, and drainage volume of VAC group and control group were collected by retrospective method and were statistically compared by independent-samples t test. There were no significant differences between two groups among age, mode of breast cancer surgery and selection of incision, clinical stage and histopathological type of breast cancer, average volume of subcutaneous effusion before treatment, and body mass index (P>0.05). The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Sichuan Academy of Medical Science & Sichuan Provincial People′s Hospital (East Branch). Informed consent was obtained from each participant. Results Average healing time in VAC group was (15.7±4.4) d, which was significantly shorter than that in control group (33.2±3.7) d, and the difference was statistically significant (t=8.362, P=0.004). Average drainage time in VAC group was (6.2±3.5) d, which was significantly shorter than that in control group (25.8±5.0) d, and the difference was statistically significant (t=11.293, P<0.001). Average drainage volume in VAC group was (283.5±2.8) mL, which was significantly lower than that in control group (369.4±3.7) mL, and the difference was statistically significant (t=9.472, P=0.016). Conclusions Treatment of breast cancer postoperative severe subcutaneous effusion by VAC is much better than that of conventional drainage. VAC treatment can reduce drainage volume, and shorten the treatment time and drainage time. But whether it is worthy of wide clinical application, large-sample and multi-center randomized controlled trial will be needed to confirm. Key words: Negative-pressure wound therapy; Subcutaneous effusion; Exudates and transudates; Breast neoplasms; Women