Objective: To define the correct time to remove the drain after axillary dissection for carcinoma of the breast.
Design: Prospective randomised trial.
Setting: Two public hospitals, Israel.
Subjects: 90 women who required axillary dissection for carcinoma of the breast.
Interventions: 42 were randomised to have the drain removed on postoperative day 3, and 48 to keep the drain in until discharge had decreased to less than 35 ml/24 hours.
Main outcome measures: Formation of seromas or wound infections, need to reinsert the drain, and duration of hospital stay.
Results: Early removal of the axillary drain was associated with a significantly higher incidence of seromas (9/42 compared with 2/48, p = 0.02) unless the total amount of fluid drained during the first three postoperative days was less than 250 ml.
Conclusion: Drains should be removed after axillary dissection only when the daily amount of fluid discharged is low, unless the drainage during the first three days is less than 250 ml.