P047. Drain Usage and Associated Complications in Mastectomies and Axillary Clearance During the 2020 COVID-19 Pandemic

Introduction: During the COVID-19 pandemic, NHS hospitals were advised to suspend all non-urgent elective surgery from April 15th. Urgent cancer treatment continued unaffected, with extra capacity provided within private sector hospitals. Research has shown drain usage is controversial in breast surgery. Consequently, drain usage was discouraged, aiming to reduce face-to face contact. We examined seroma and haematoma rates in postoperative patients undergoing procedures where drains would normally be placed, alongside the prevalence of ongoing drain utilisation during this period. Method: All operations performed during the COVID-19 pandemic between the 15/4/2020 and the 3/7/2020 were identified. Patients undergoing mastectomy and/or axillary clearance were identified, with operation notes and follow up letters reviewed until 6 weeks post procedure. Rates of seroma and haematoma requiring intervention in patients who had and hadn't had drains inserted were compared using a chi-squared test. Results: 22 patients had mastectomies during this time (with 3 additionally having an axillary clearance). Drains were used in 15 patients. Of those with a drain, 1 required intervention for seroma/haematoma (6.7%), compared to 3 without drains (42.9%, p= 0.04). Discussion: In a small sample size, a seroma/haematoma rate of 45% (10 patients), was found amongst patients having mastectomies. However, of these only 4 required intervention. Evaluation of the results showed there is a statistically significant difference between the need for intervention for those with and without drains. As a result, since the pandemic first wave, most surgeons within our unit have reverted to the use of drains in higher risk procedures.