Safety and feasibility of early postmastectomy discharge and home drain care in a low resource setting
Background Early postmastectomy discharge with a drain in place is standard practice in most developed countries. Its feasibility has not been evaluated in low resource settings like Nigeria. Methods Consenting patients undergoing mastectomy were discharged on the third postoperative day and assesse...
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| Veröffentlicht in: | Journal of surgical oncology 2018-11, Vol.118 (6), p.861-866 |
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| container_title | Journal of surgical oncology |
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| creator | Olasehinde, Olalekan Alatise, Olusegun Arowolo, Olukayode Adisa, Adewale Wuraola, Funmilola Boutin‐Foster, Carla Lawal, Oladejo Kingham, Thomas |
| description | Background
Early postmastectomy discharge with a drain in place is standard practice in most developed countries. Its feasibility has not been evaluated in low resource settings like Nigeria.
Methods
Consenting patients undergoing mastectomy were discharged on the third postoperative day and assessed as outpatients for wound complications as well as their experience at home. Wound outcomes were compared with patients who had traditional long stay.
Results
Forty‐five of the 58 patients who had a mastectomy during the study period participated in the early discharge program (77.6%). Of these, four patients (8.9%) had drain malfunction, seroma occurred in eight patients (17.8%), eight patients (17.8%) had wound infection, and six patients (13.3%) had flap necrosis. There was no readmission. Compared with long stay patients, postoperative stay was significantly shorter (3 vs 11 days; P |
| doi_str_mv | 10.1002/jso.25215 |
| format | Article |
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Early postmastectomy discharge with a drain in place is standard practice in most developed countries. Its feasibility has not been evaluated in low resource settings like Nigeria.
Methods
Consenting patients undergoing mastectomy were discharged on the third postoperative day and assessed as outpatients for wound complications as well as their experience at home. Wound outcomes were compared with patients who had traditional long stay.
Results
Forty‐five of the 58 patients who had a mastectomy during the study period participated in the early discharge program (77.6%). Of these, four patients (8.9%) had drain malfunction, seroma occurred in eight patients (17.8%), eight patients (17.8%) had wound infection, and six patients (13.3%) had flap necrosis. There was no readmission. Compared with long stay patients, postoperative stay was significantly shorter (3 vs 11 days; P < 0.01) with significant cost savings, while complication rates were not statistically different. All the patients in the early discharge group were confident operating their drains and preferred early discharge. Being around relatives, reduced cost, and fear of the hospital environment were common reasons cited for their preference.
Conclusion
Our results support the implementation of an early postmastectomy discharge program in a low resource setting.</description><identifier>ISSN: 0022-4790</identifier><identifier>EISSN: 1096-9098</identifier><identifier>DOI: 10.1002/jso.25215</identifier><identifier>PMID: 30293243</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adult ; Age Factors ; Aged ; Aged, 80 and over ; breast ; Breast Neoplasms - pathology ; Breast Neoplasms - surgery ; Cancer surgery ; Cost control ; Drainage - adverse effects ; Drainage - methods ; Female ; Humans ; Length of Stay ; Mastectomy ; Mastectomy - adverse effects ; Mastectomy - economics ; Mastectomy - methods ; Middle Aged ; Neoplasm Staging ; Nigeria ; Patient Discharge ; Patient Satisfaction ; Postoperative Care - adverse effects ; Postoperative Care - economics ; Postoperative Care - methods ; Prospective Studies ; seroma ; Socioeconomic Factors ; Surgical Wound - therapy</subject><ispartof>Journal of surgical oncology, 2018-11, Vol.118 (6), p.861-866</ispartof><rights>2018 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4545-f24dad57a234e9bc51cb80d2e1b25a7b96617aa200cb555a897386304689a3133</citedby><cites>FETCH-LOGICAL-c4545-f24dad57a234e9bc51cb80d2e1b25a7b96617aa200cb555a897386304689a3133</cites><orcidid>0000-0002-3359-3186 ; 0000-0002-8706-0756</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjso.25215$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjso.25215$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30293243$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Olasehinde, Olalekan</creatorcontrib><creatorcontrib>Alatise, Olusegun</creatorcontrib><creatorcontrib>Arowolo, Olukayode</creatorcontrib><creatorcontrib>Adisa, Adewale</creatorcontrib><creatorcontrib>Wuraola, Funmilola</creatorcontrib><creatorcontrib>Boutin‐Foster, Carla</creatorcontrib><creatorcontrib>Lawal, Oladejo</creatorcontrib><creatorcontrib>Kingham, Thomas</creatorcontrib><title>Safety and feasibility of early postmastectomy discharge and home drain care in a low resource setting</title><title>Journal of surgical oncology</title><addtitle>J Surg Oncol</addtitle><description>Background
Early postmastectomy discharge with a drain in place is standard practice in most developed countries. Its feasibility has not been evaluated in low resource settings like Nigeria.
Methods
Consenting patients undergoing mastectomy were discharged on the third postoperative day and assessed as outpatients for wound complications as well as their experience at home. Wound outcomes were compared with patients who had traditional long stay.
Results
Forty‐five of the 58 patients who had a mastectomy during the study period participated in the early discharge program (77.6%). Of these, four patients (8.9%) had drain malfunction, seroma occurred in eight patients (17.8%), eight patients (17.8%) had wound infection, and six patients (13.3%) had flap necrosis. There was no readmission. Compared with long stay patients, postoperative stay was significantly shorter (3 vs 11 days; P < 0.01) with significant cost savings, while complication rates were not statistically different. All the patients in the early discharge group were confident operating their drains and preferred early discharge. Being around relatives, reduced cost, and fear of the hospital environment were common reasons cited for their preference.
Conclusion
Our results support the implementation of an early postmastectomy discharge program in a low resource setting.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>breast</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - surgery</subject><subject>Cancer surgery</subject><subject>Cost control</subject><subject>Drainage - adverse effects</subject><subject>Drainage - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Length of Stay</subject><subject>Mastectomy</subject><subject>Mastectomy - adverse effects</subject><subject>Mastectomy - economics</subject><subject>Mastectomy - methods</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Nigeria</subject><subject>Patient Discharge</subject><subject>Patient Satisfaction</subject><subject>Postoperative Care - adverse effects</subject><subject>Postoperative Care - economics</subject><subject>Postoperative Care - methods</subject><subject>Prospective Studies</subject><subject>seroma</subject><subject>Socioeconomic Factors</subject><subject>Surgical Wound - therapy</subject><issn>0022-4790</issn><issn>1096-9098</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kE1LxDAQhoMoun4c_AMS8KKHaj6b5iiLnwge1HOZplPt0jZr0kX6742uehA8DcM88_DyEnLI2RlnTJwvoj8TWnC9QWac2TyzzBabZJZuIlPGsh2yG-OCMWZtrrbJjmTCSqHkjDSP0OA4URhq2iDEtmq7Nu2-oQihm-jSx7GHOKIbfT_Ruo3uFcILfn28-h5pHaAdqIOANE2gnX-nAaNfBYc04ji2w8s-2Wqgi3jwPffI89Xl0_wmu3-4vp1f3GdOaaWzRqgaam1ASIW2cpq7qmC1QF4JDaayec4NgGDMVVprKKyRRS6ZygsLkku5R07W3mXwbyuMY9mnwNh1MKBfxVJwbrg2SqqEHv9BFynykNIlSmhutCk-hadrygUfY8CmXIa2hzCVnJWf5Zep_PKr_MQefRtXVY_1L_nTdgLO18B72-H0v6m8e3xYKz8ASpeNUw</recordid><startdate>20181101</startdate><enddate>20181101</enddate><creator>Olasehinde, Olalekan</creator><creator>Alatise, Olusegun</creator><creator>Arowolo, Olukayode</creator><creator>Adisa, Adewale</creator><creator>Wuraola, Funmilola</creator><creator>Boutin‐Foster, Carla</creator><creator>Lawal, Oladejo</creator><creator>Kingham, Thomas</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3359-3186</orcidid><orcidid>https://orcid.org/0000-0002-8706-0756</orcidid></search><sort><creationdate>20181101</creationdate><title>Safety and feasibility of early postmastectomy discharge and home drain care in a low resource setting</title><author>Olasehinde, Olalekan ; Alatise, Olusegun ; Arowolo, Olukayode ; Adisa, Adewale ; Wuraola, Funmilola ; Boutin‐Foster, Carla ; Lawal, Oladejo ; Kingham, Thomas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4545-f24dad57a234e9bc51cb80d2e1b25a7b96617aa200cb555a897386304689a3133</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>breast</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - surgery</topic><topic>Cancer surgery</topic><topic>Cost control</topic><topic>Drainage - adverse effects</topic><topic>Drainage - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Length of Stay</topic><topic>Mastectomy</topic><topic>Mastectomy - adverse effects</topic><topic>Mastectomy - economics</topic><topic>Mastectomy - methods</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Nigeria</topic><topic>Patient Discharge</topic><topic>Patient Satisfaction</topic><topic>Postoperative Care - adverse effects</topic><topic>Postoperative Care - economics</topic><topic>Postoperative Care - methods</topic><topic>Prospective Studies</topic><topic>seroma</topic><topic>Socioeconomic Factors</topic><topic>Surgical Wound - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Olasehinde, Olalekan</creatorcontrib><creatorcontrib>Alatise, Olusegun</creatorcontrib><creatorcontrib>Arowolo, Olukayode</creatorcontrib><creatorcontrib>Adisa, Adewale</creatorcontrib><creatorcontrib>Wuraola, Funmilola</creatorcontrib><creatorcontrib>Boutin‐Foster, Carla</creatorcontrib><creatorcontrib>Lawal, Oladejo</creatorcontrib><creatorcontrib>Kingham, Thomas</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Olasehinde, Olalekan</au><au>Alatise, Olusegun</au><au>Arowolo, Olukayode</au><au>Adisa, Adewale</au><au>Wuraola, Funmilola</au><au>Boutin‐Foster, Carla</au><au>Lawal, Oladejo</au><au>Kingham, Thomas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Safety and feasibility of early postmastectomy discharge and home drain care in a low resource setting</atitle><jtitle>Journal of surgical oncology</jtitle><addtitle>J Surg Oncol</addtitle><date>2018-11-01</date><risdate>2018</risdate><volume>118</volume><issue>6</issue><spage>861</spage><epage>866</epage><pages>861-866</pages><issn>0022-4790</issn><eissn>1096-9098</eissn><abstract>Background
Early postmastectomy discharge with a drain in place is standard practice in most developed countries. Its feasibility has not been evaluated in low resource settings like Nigeria.
Methods
Consenting patients undergoing mastectomy were discharged on the third postoperative day and assessed as outpatients for wound complications as well as their experience at home. Wound outcomes were compared with patients who had traditional long stay.
Results
Forty‐five of the 58 patients who had a mastectomy during the study period participated in the early discharge program (77.6%). Of these, four patients (8.9%) had drain malfunction, seroma occurred in eight patients (17.8%), eight patients (17.8%) had wound infection, and six patients (13.3%) had flap necrosis. There was no readmission. Compared with long stay patients, postoperative stay was significantly shorter (3 vs 11 days; P < 0.01) with significant cost savings, while complication rates were not statistically different. All the patients in the early discharge group were confident operating their drains and preferred early discharge. Being around relatives, reduced cost, and fear of the hospital environment were common reasons cited for their preference.
Conclusion
Our results support the implementation of an early postmastectomy discharge program in a low resource setting.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>30293243</pmid><doi>10.1002/jso.25215</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-3359-3186</orcidid><orcidid>https://orcid.org/0000-0002-8706-0756</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Age Factors Aged Aged, 80 and over breast Breast Neoplasms - pathology Breast Neoplasms - surgery Cancer surgery Cost control Drainage - adverse effects Drainage - methods Female Humans Length of Stay Mastectomy Mastectomy - adverse effects Mastectomy - economics Mastectomy - methods Middle Aged Neoplasm Staging Nigeria Patient Discharge Patient Satisfaction Postoperative Care - adverse effects Postoperative Care - economics Postoperative Care - methods Prospective Studies seroma Socioeconomic Factors Surgical Wound - therapy |
| title | Safety and feasibility of early postmastectomy discharge and home drain care in a low resource setting |
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