Hydrochlorothiazide diuretic helps with fluid drainage during breast reconstruction

Hydrochlorothiazide helps lessen the accumulation of interstitial fluid during deep inferior epigastric perforator (DIEP) flap breast reconstruction, a recent study has shown.

Researchers enrolled 60 breast cancer patients who had undergone skin- or nipple-sparing mastectomy and DIEP flap reconstruction. Participants were randomly assigned to receive daily 25-mg hydrochlorothiazide tablets, from the second to the twentieth day after surgery (n=30; mean age, 49.76±6.68 years), or no diuretic (n=30; mean age, 48.67±7.908). Drainage volume and time were some of the study outcomes.

At the donor site, the average total drainage volume removed was 291 mL in the hydrochlorothiazide group, significantly lower than the 436-mL volume in the control group (p=0.003). Similarly, the volume drained at the recipient site was significantly lower in the treatment group (200 vs 286 mL; p=0.032).

In the treatment arm, drainage tubes at the abdominal site was removed after a mean of 7.5 days, while those at the breast were taken off after 6.3 days. The corresponding time intervals to tube removal in the control group were 10.90 and 7.6 days, respectively. The resulting difference in the time needed to remove all drainage tubes was statistically significant (p=0.002).

Moreover, the hydrochlorothiazide tablets significantly reduced the risk of seroma development (16.7 percent vs 43.3 percent; odds ratio, 0.262, 95 percent confidence interval, 0.058–0.858; p=0.024).

“No significant adverse effects were reported in this study; however, additional research in a large-scale multiracial cohort is required before using hydrochlorothiazide as a seroma prevention medication,” the researchers said.