Early discharge after mastectomy. A safe way of diminishing hospital costs

R. K. Orr, A. S. Ketcham, D. S. Robinson, Frederick L Moffat, N. D. Tennant

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

In order to assess the risks and benefits of early discharge after major breast surgery, the authors analyzed 73 consecutive private patients who underwent operations by four surgeons over a 1-year period. Patient's ages ranged from 34 to 84 years, with a mean of 56.2 years. One patient was excluded from analysis because thoracotomy with a pulmonary resection was performed during the same hospitalization. Thirty-seven patients underwent total mastectomy with complete axillary dissection, 30 underwent segmental mastectomy with complete axillary dissection, and five underwent total mastectomy alone. For each patient the chest wall and axilla were drained by means of one or two Jackson-Pratt (American Heyer Schulte Corp., Goleta, CA) closed suction drains. Prior to discharge, all patients were instructed in the proper technique of drain care and were directed to record the daily drainage. Patients were discharged when they were fully mobile, did not require injectable narcotics, and felt capable of taking care of the drains as outpatients. The length of postoperative stay ranged from 1 to 9 days (mean 2.9) with all but three patients being discharged by the fifth postoperative day. Patient acceptance of early discharge with drains was excellent. Drains were pulled on an outpatient basis, usually within 7 to 10 days after surgery. Complications were observed in twelve patients (18%), consisting of seromas (8 patients), cellulitis (2 patients), and minimal superficial skin necrosis (2 patients). All complications were managed easily on an outpatient basis. We conclude that early discharge with Jackson-Pratt drains remaining in plase is safe, well tolerated by patients, and had tremendous potential for substantial cost savings.

Original languageEnglish
Pages (from-to)161-163
Number of pages3
JournalAmerican Surgeon
Volume53
Issue number3
StatePublished - May 13 1987
Externally publishedYes

Fingerprint

Hospital Costs
Mastectomy
Simple Mastectomy
Outpatients
Dissection
Seroma
Axilla
Cellulitis
Segmental Mastectomy
Cost Savings
Patient Discharge
Narcotics
Suction
Thoracic Wall
Thoracotomy
Ambulatory Surgical Procedures
Drainage
Length of Stay
Hospitalization
Breast

ASJC Scopus subject areas

  • Surgery

Cite this

Orr, R. K., Ketcham, A. S., Robinson, D. S., Moffat, F. L., & Tennant, N. D. (1987). Early discharge after mastectomy. A safe way of diminishing hospital costs. American Surgeon, 53(3), 161-163.

Early discharge after mastectomy. A safe way of diminishing hospital costs. / Orr, R. K.; Ketcham, A. S.; Robinson, D. S.; Moffat, Frederick L; Tennant, N. D.

In: American Surgeon, Vol. 53, No. 3, 13.05.1987, p. 161-163.

Research output: Contribution to journalArticle

Orr, RK, Ketcham, AS, Robinson, DS, Moffat, FL & Tennant, ND 1987, 'Early discharge after mastectomy. A safe way of diminishing hospital costs', American Surgeon, vol. 53, no. 3, pp. 161-163.
Orr RK, Ketcham AS, Robinson DS, Moffat FL, Tennant ND. Early discharge after mastectomy. A safe way of diminishing hospital costs. American Surgeon. 1987 May 13;53(3):161-163.
Orr, R. K. ; Ketcham, A. S. ; Robinson, D. S. ; Moffat, Frederick L ; Tennant, N. D. / Early discharge after mastectomy. A safe way of diminishing hospital costs. In: American Surgeon. 1987 ; Vol. 53, No. 3. pp. 161-163.
@article{da5a509e9dee450eb4ad9e7599fcacf1,
title = "Early discharge after mastectomy. A safe way of diminishing hospital costs",
abstract = "In order to assess the risks and benefits of early discharge after major breast surgery, the authors analyzed 73 consecutive private patients who underwent operations by four surgeons over a 1-year period. Patient's ages ranged from 34 to 84 years, with a mean of 56.2 years. One patient was excluded from analysis because thoracotomy with a pulmonary resection was performed during the same hospitalization. Thirty-seven patients underwent total mastectomy with complete axillary dissection, 30 underwent segmental mastectomy with complete axillary dissection, and five underwent total mastectomy alone. For each patient the chest wall and axilla were drained by means of one or two Jackson-Pratt (American Heyer Schulte Corp., Goleta, CA) closed suction drains. Prior to discharge, all patients were instructed in the proper technique of drain care and were directed to record the daily drainage. Patients were discharged when they were fully mobile, did not require injectable narcotics, and felt capable of taking care of the drains as outpatients. The length of postoperative stay ranged from 1 to 9 days (mean 2.9) with all but three patients being discharged by the fifth postoperative day. Patient acceptance of early discharge with drains was excellent. Drains were pulled on an outpatient basis, usually within 7 to 10 days after surgery. Complications were observed in twelve patients (18{\%}), consisting of seromas (8 patients), cellulitis (2 patients), and minimal superficial skin necrosis (2 patients). All complications were managed easily on an outpatient basis. We conclude that early discharge with Jackson-Pratt drains remaining in plase is safe, well tolerated by patients, and had tremendous potential for substantial cost savings.",
author = "Orr, {R. K.} and Ketcham, {A. S.} and Robinson, {D. S.} and Moffat, {Frederick L} and Tennant, {N. D.}",
year = "1987",
month = "5",
day = "13",
language = "English",
volume = "53",
pages = "161--163",
journal = "The American surgeon",
issn = "0003-1348",
publisher = "Southeastern Surgical Congress",
number = "3",

}

TY - JOUR

T1 - Early discharge after mastectomy. A safe way of diminishing hospital costs

AU - Orr, R. K.

AU - Ketcham, A. S.

AU - Robinson, D. S.

AU - Moffat, Frederick L

AU - Tennant, N. D.

PY - 1987/5/13

Y1 - 1987/5/13

N2 - In order to assess the risks and benefits of early discharge after major breast surgery, the authors analyzed 73 consecutive private patients who underwent operations by four surgeons over a 1-year period. Patient's ages ranged from 34 to 84 years, with a mean of 56.2 years. One patient was excluded from analysis because thoracotomy with a pulmonary resection was performed during the same hospitalization. Thirty-seven patients underwent total mastectomy with complete axillary dissection, 30 underwent segmental mastectomy with complete axillary dissection, and five underwent total mastectomy alone. For each patient the chest wall and axilla were drained by means of one or two Jackson-Pratt (American Heyer Schulte Corp., Goleta, CA) closed suction drains. Prior to discharge, all patients were instructed in the proper technique of drain care and were directed to record the daily drainage. Patients were discharged when they were fully mobile, did not require injectable narcotics, and felt capable of taking care of the drains as outpatients. The length of postoperative stay ranged from 1 to 9 days (mean 2.9) with all but three patients being discharged by the fifth postoperative day. Patient acceptance of early discharge with drains was excellent. Drains were pulled on an outpatient basis, usually within 7 to 10 days after surgery. Complications were observed in twelve patients (18%), consisting of seromas (8 patients), cellulitis (2 patients), and minimal superficial skin necrosis (2 patients). All complications were managed easily on an outpatient basis. We conclude that early discharge with Jackson-Pratt drains remaining in plase is safe, well tolerated by patients, and had tremendous potential for substantial cost savings.

AB - In order to assess the risks and benefits of early discharge after major breast surgery, the authors analyzed 73 consecutive private patients who underwent operations by four surgeons over a 1-year period. Patient's ages ranged from 34 to 84 years, with a mean of 56.2 years. One patient was excluded from analysis because thoracotomy with a pulmonary resection was performed during the same hospitalization. Thirty-seven patients underwent total mastectomy with complete axillary dissection, 30 underwent segmental mastectomy with complete axillary dissection, and five underwent total mastectomy alone. For each patient the chest wall and axilla were drained by means of one or two Jackson-Pratt (American Heyer Schulte Corp., Goleta, CA) closed suction drains. Prior to discharge, all patients were instructed in the proper technique of drain care and were directed to record the daily drainage. Patients were discharged when they were fully mobile, did not require injectable narcotics, and felt capable of taking care of the drains as outpatients. The length of postoperative stay ranged from 1 to 9 days (mean 2.9) with all but three patients being discharged by the fifth postoperative day. Patient acceptance of early discharge with drains was excellent. Drains were pulled on an outpatient basis, usually within 7 to 10 days after surgery. Complications were observed in twelve patients (18%), consisting of seromas (8 patients), cellulitis (2 patients), and minimal superficial skin necrosis (2 patients). All complications were managed easily on an outpatient basis. We conclude that early discharge with Jackson-Pratt drains remaining in plase is safe, well tolerated by patients, and had tremendous potential for substantial cost savings.

UR - http://www.scopus.com/inward/record.url?scp=0023146194&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0023146194&partnerID=8YFLogxK

M3 - Article

C2 - 3826907

AN - SCOPUS:0023146194

VL - 53

SP - 161

EP - 163

JO - The American surgeon

JF - The American surgeon

SN - 0003-1348

IS - 3

ER -