New Occupational Therapy Service for Patients with Breast Cancer: Pilot Project on the Use of Tailor-made Pressure Garment for (i) Improving Post-surgical Drainage and Seroma Control, (ii) Protection of Surgical Wound and (iii) Pain Reduction

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Authors (including presenting author) :
Au WY(1),Leung YH(1),Yeung HY(1),Chan MW(1),Ling YH(2),Tong SH(2),Yuen FCG(1)
Affiliation :
(1)Occupational Therapy Department,(2)Department of Surgery,
Ruttonjee & Tang Shiu Kin Hospitals
Introduction :
A multi-disciplinary breast team was newly formed in 2018 to improve the service standard of breast surgery for cancer patients in Ruttonjee Hospital. Since February 2018, the Occupational Therapy Department has commenced a new service of providing “Tailor-made Pressure Garments” to these patients for post-operative care without extra resources. Three features have been incorporated into the service design:
1. Earliest intervention is enhanced. Fitting of pressure garment will be provided at the earliest instance on post-operative day one.
2. Individual approach is adopted to take measurement, draw pattern, sew garment, and choose appropriate fabrics and fasteners to meet individual needs.
3. Individual/group treatments will be provided to improve patients’ compliance and reduce their anxiety.
Objectives :
(1) Improving post-surgical drainage and seroma control; (2) Providing protection to operation wound and (3) Reducing wound pain.
Methodology :
This is a report based on the treatment data of 33 patients during the period from February 2018 to January 2019. Recruitment of patients:
All 33 subjects received breast surgery in Ruttonjee Hospital and referred by surgeon for the provision of pressure garment. Sources of Data for analysis:
Data were collected from CMS system, case files and from patient interviews.
Result & Outcome :
1. Average duration of drainage of 33 patients: 10.7+5.5 days Breakdown of drainage duration after different surgical procedures:
(i) Modified radical mastectomy: 13.9+4.8 days
(ii) Total mastectomy: 10.3+1.6 days (iii)Lumpectomy/Wide local excision: 5.4+4.4 days 2. Only 3 out of 33 patients (9.1%) had problem of seroma formation. 3. Amount of seroma collected was minimal. Excluding the patient (in one case) with severe complications, the average seroma aspirated among the three patients was 10 ml and each patient underwent 1 aspiration only. 4. Overall patient satisfaction survey on the pressure garment was good. The survey areas covered garment breathability, skin comfort, wound protection, pain reduction, easy application and overall satisfaction. The mean, median and mode scores of the overall satisfaction are 8.6, 9.0 and 10.0 out of 10 respectively. Conclusion: The three objectives of the pilot project were satisfactorily achieved.

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