Submited on: 28 Feb 2015 01:59:50 PM GMT
Published on: 02 Mar 2015 01:31:33 PM GMT
 
Modified Radical Mastectomy and Wound Drainage
Posted by Dr. Prasan K Hota on 08 Jul 2015 08:54:26 AM GMT Reviewed by Author Invited Reviewers

  • What are the main claims of the paper and how important are they?

    Drains are required in case of MRM. Suction drain particularly 02 in numbers must be used to drain the dead space created by MRM and axilla respectively.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    No. Suction drains are in used routinely in case of MRM since long.


  • Are the claims properly placed in the context of the previous literature?

    Yes


  • Do the results support the claims? If not, what other evidence is required?

    This is only a review. The authors have not given any details of their study. The authors should have done a proper study and then they should have compared their results with that of previous studies available in the literature.


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    .


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    N/A


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    Findings from the studies done by authors if any should have been mentioned . They should have been compared with available data from other such similar studies.


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    No. There is nothing new. There is no mention of the work of the authors in this regard.


  • Other Comments:

    N/A

  • Invited by the author to review this article? :
    Yes
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    Regularly, we put 02 suction drains in case of MRM - one in the breast area and the other one in axilla. Placement of two suction frains are mandatory in case of MRM.

  • How to cite:  Hota P K.Modified Radical Mastectomy and Wound Drainage[Review of the article ' Modified Radical Mastectomy and Wound Drainage ' by Deodhar M].WebmedCentral 2015;6(7):WMCRW003229
1 2 3 4 5 6 7 8 9
Report abuse
 
Modified radical mastectomy - To drain or not to drain
Posted by Prof. Sanjeev K Gupta on 23 Mar 2015 08:44:14 AM GMT Reviewed by WMC Editors

  • What are the main claims of the paper and how important are they?

    The main claim of the paper is to try and find out the necessity for a drainage after Modified radical mastectomy.

    Advantages and disadvantages of drainage

    Type of drainage


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    No these claims are not novel. The incidence of seroma after MRM is in the range of 20-80% and is generally considered that seroma will occur whether drainage is done or not.

    1. Troost MS, Kempes CJ, deRoos MA. Breast cancer surgery without drains: No influences on seroma formation. Int J Surg 2015; 13: 170-4

    2. Eichler C, Dahdouh F, Fischer P, Warm M. No drain mastectomy - Preventing seroma using TissuGluR: a small case series. Ann Med Surg 2014; 3: 82-84


  • Are the claims properly placed in the context of the previous literature?

    The literature has not been reviewed in detail.


  • Do the results support the claims? If not, what other evidence is required?

    The authors have not given any results. They have only reviewed the literature and that too sketchily.


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    No protocol provided


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    No


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    A RCT should be planned and carried out. It is not very difficult


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    No. This article is not outstanding because the authors have just made a general observation.


  • Other Comments:

    This article does not add much to the existing controversy

  • Invited by the author to review this article? :
    Yes
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    I am Professor of Surgery at Institute of Medical Sciences, Banaras Hindu University with a clinical experience of 25 years with an interest in breast cancer

  • How to cite:  Gupta S K.Modified radical mastectomy - To drain or not to drain[Review of the article ' Modified Radical Mastectomy and Wound Drainage ' by Deodhar M].WebmedCentral 2015;6(3):WMCRW003198
1 2 3 4 5 6 7 8 9
Report abuse
 
Modified Radical Mastectomy and Wound Drainage
Posted by Anonymous Reviewer on 04 Mar 2015 01:37:31 PM GMT Reviewed by Author Invited Reviewers

  • What are the main claims of the paper and how important are they?

    Yes it is an important  topic as claimed in article. 


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    Yes but the topic has been very superficially touched.


  • Are the claims properly placed in the context of the previous literature?

    No there is no review of the related articles on this topic


  • Do the results support the claims? If not, what other evidence is required?

    Not applicable


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    Not applicable


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    Not applicable


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    Yes definitely it would improve the article.


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    No, it is a very superficial article and does not go in the depth of this subject.


  • Other Comments:

    Should include and analyse some more work that has been done in the literature

  • Invited by the author to review this article? :
    Yes
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    Yes

  • How to cite:  Anonymous.Modified Radical Mastectomy and Wound Drainage[Review of the article ' Modified Radical Mastectomy and Wound Drainage ' by Deodhar M].WebmedCentral 2015;6(3):WMCRW003190
1 2 3 4 5 6 7 8 9
Report abuse
 
Modified Radical Mastectomy and Wound Drainage
Posted by Dr. KETAN R VAGHOLKAR on 02 Mar 2015 04:18:28 PM GMT Reviewed by WMC Editors

  • What are the main claims of the paper and how important are they?

    The paper discusses a very important factor in breast surgery for cancer. The successful outcome of MRM is largely dependent upon effective drainage of collected body fluids comprisisng of blood, lymph and tissue fluid. The best method for draing this fluid is discussed.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    The claims are novel. But a assertive conclusion based on personal experience is lacking.


  • Are the claims properly placed in the context of the previous literature?

    Yes.


  • Do the results support the claims? If not, what other evidence is required?

    The article is a review article. However the discussion needs more elaboration.


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    Not applicable as the article is a review article.


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    Not applicable.


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    More elaborate details pertaining to the time frame for removal of the drain is of utmost importance. Well defined clinical criteria are essential for deciding the time for removal of the drain.


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    The topic raised is vital for successful outcome in MRM procedure. Comparison of available data with peronal experiences is essential for developing a good protocol.

     


  • Other Comments:

    Romovac drain is a very effective method for draining the fluid. In my practice I usually keep the drain for  a period ranging from 5 to 9 days. The criteria for removal of the drain is that the drainage should be less than 10cc on two consecutive days. This needs to be correlated with abscence of any swelling  in the operated area.

    With repect to the viability of flaps a geometric marking of the flaps before raising them is pivitol for a positive outcome.A pentoxyphylline drip in the immediate postoperative period may be helpful in doubtful cases.

    Wound infection can be kept to a bare minimum by intraoperative irrigation with a solution of hypertonic saline and dilute hydrogen peroxide. This combination is both tumoricidal as well as has antibacterial effect. Topical use of injection chloramphenicol powder is also of great help.

    Suture removal is advisable on day 12.

    Immediate use of a elastocrepe bandage continued for 14 days helps t prevent lymphedema of the ipsilaterla limb.

    The aforementioned measures has given excellent results.

  • Invited by the author to review this article? :
    Yes
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    Extensive work on breast surgery with publications on the topic.

  • How to cite:  VAGHOLKAR K R.Modified Radical Mastectomy and Wound Drainage[Review of the article ' Modified Radical Mastectomy and Wound Drainage ' by Deodhar M].WebmedCentral 2015;6(3):WMCRW003188
1 2 3 4 5 6 7 8 9
Report abuse