Cost minimization while ensuring safety of reduction mammaplasty

Abstract

A prospective randomized study was designed to address the safety of performing reduction mammaplasty without drains. In the same cohort, the postoperative pain requirements, length of stay and complications were recorded in an effort to document the efficacy of performing this surgery in an outpatient setting. All women presenting for reduction mammaplasty at the Royal Victoria Hospital during a one-year period were asked to participate in the study. A total of 75 patients enrolled, and complete data were available at the 28-day follow-up for all women. The overall hematoma rate was 0% with drains and 2.7% without drains. The observed infection rate was 8% with drains and 5% without drains. There is no statistically significant or clinically meaningful difference in complication rates between breasts treated with drains and those treated without drains. In addition, 90% of women can be managed with oral analgesics within 23 h of surgery. Combined, this information suggests a potential cost savings of 57% based on prestudy observations. Careful analysis of the process of care will continue to enable the care of patients to be more efficient without compromising quality or safety.