Introduction
The British Association of Day Surgery outlines a 75% day- case target for simple mastectomy procedures. The closure of dead space between the wound surfaces and applied tissues is fundamental in reducing mastectomy’s post- operative seromas and several methods have been used. Our geographical location is home to one of the highest over 65’s populations in the UK with multiple social issues and comorbidities, a fact that impedes day case rate. We conducted a study using a fibrin sealant spray instead of drains in simple mastectomies to assess the length of stay and the rate of common post- operative complications.
Method
The study included 236 consecutive mastectomies irrespective of age, BMI, social demographics and comorbidities. The data collection was prospective including demographics, the length of hospital stays, day case rate, seromas, haematomas and wound infections. EXCEL was used for data analysis.
Results
The mean age was 67 years; average BMI was 28 Kg/m2 , and the average specimen weight was 720 g. A day case rate of 59% was achieved. 41% of the patients were admitted mostly for social reasons. 42% developed seromas. Wound infection rate was 18%. Only 2 patients developed haematoma.
Conclusion
ARTISS enables drainless mastectomies and higher rates of day cases in all demographic groups. However, we have not met the national day case target, primarily due to the key barriers are the social issues related to elderly population in our region that pose difficulties on same day discharge plan.
Authors
Saahil Hegde
University Hospital Sussex NHS Foundation Trust, Brighton and Hove, United Kingdom
Amani Asour
Medway NHS Foundation Trust, Gillingham, United Kingdom
Elizabeth Shah
East Sussex Healthcare NHS Trust, Hastings, United Kingdom