Early Showering After Surgery for Breast Reconstruction Recovery

Age: 18+

Sex: Female

Trial Phase: Academic

Sponsor: University of Missouri-Columbia

Disqualifiers: Existing wounds, Previous infections, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 90 days

100 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial examines whether showering 48 hours after breast reconstruction surgery, while drain tubes remain in place, increases infection risk or affects recovery. Participants will be divided into two groups: one group can shower with the tubes in, while the other must wait until tube removal. The goal is to determine if early showering (48 hours post-surgery) alters infection risk or affects recovery experience. This trial targets individuals who have undergone breast surgery with tissue expanders and drains, without existing wounds or past implant-related infections. As an unphased trial, it offers a chance to contribute to research that could enhance post-surgical care for future patients.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that early showering after surgery is safe?

Research has shown that showering soon after surgery, even with drain tubes, is safe and doesn't increase the risk of infections or complications. One study found that patients who showered early experienced no more issues than those who waited. Another study confirmed that it's safe to shower 24 hours after surgery if the wound is low-risk. Patients with closed suction drainage, a type of surgical drain, also did not experience more infections when showering early. Overall, the evidence suggests that showering early poses no additional safety risks. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores whether early showering—just 48 hours after breast reconstruction surgery—can safely aid recovery, even with drain tubes still in place. Traditionally, patients have to wait until these tubes are removed to shower, which can take several days or even weeks. This trial aims to find out if early showering might improve comfort and reduce the burden of post-surgery care without increasing infection risks. If successful, this method could offer patients greater freedom and a quicker return to normal activities.

What evidence suggests that early showering after surgery is effective for breast reconstruction recovery?

This trial will compare two approaches to postoperative showering for breast reconstruction recovery. Research has shown that showering 48 hours after surgery, even with drain tubes, is safe. This approach, used for one group in the trial, does not increase the risk of infections or other complications. Patients who showered early did not experience more issues than those who waited longer. In fact, showering sooner might enhance comfort and improve quality of life. Some studies suggest that early showering can aid in feeling better and healing faster. Overall, starting to shower sooner appears to be a safe choice for those recovering from breast reconstruction surgery. ^{1 2 3 6 7}

Are You a Good Fit for This Trial?

This trial is for individuals over 18 years old who are undergoing breast surgery with tissue expanders and drains. Participants must be willing to follow the study's procedures.

Inclusion Criteria

Acceptance of protocol and procedures

I am having breast surgery with a tissue expander and drains.

I am older than 18 years.

Exclusion Criteria

I currently have wounds.

History of previous infections related to implant device if delayed

I have chosen not to participate in certain treatments.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants are randomized to either shower daily after 48 hours with drains in place or wait until drains are removed before showering

90 days

Regular post-operative evaluations

Follow-up

Participants are monitored for signs of infection and complete a quality of life survey

90 days

Post-operative evaluations and survey completion

What Are the Treatments Tested in This Trial?

Interventions

• Showering 48 hours after surgery

Trial Overview The study is testing if showering 48 hours after breast reconstruction surgery with drain tubes in place affects infection rates or quality of life.

How Is the Trial Designed?

Group I: Showering 48 hours after Surgery Experimental Treatment 1 Intervention

Group 1 will be allowed to shower 48 hours after surgery with drain tubes still in place.

Group II: Showering after drain tubes are removed Active Control 1 Intervention

Group 2 will not be allowed to shower until drain tubes are removed.

Who Is Running the Clinical Trial?

University of Missouri-Columbia

Lead Sponsor

Trials

387

Recruited

629,000+

Published Research Related to This Trial

A systematic review identified only one high-risk bias trial involving 857 patients that compared early post-operative bathing (within 12 hours) to delayed bathing (after 48 hours), finding no significant difference in surgical site infections (SSIs) between the two groups (8.5% vs 8.8%).

Due to the lack of conclusive evidence and the wide confidence intervals, the study suggests that further randomized controlled trials are necessary to determine the safety and efficacy of early versus delayed post-operative bathing for preventing wound complications.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Early versus delayed post-operative bathing or showering to prevent wound complications. Toon, CD., Sinha, S., Davidson, BR., et al.[2022]

In a study involving 170 patients, allowing water contact with freshly closed surgical wounds 24 hours after surgery resulted in no observed cases of wound infection.

This finding suggests that the traditional guideline against water contact may not be necessary, as the infection rate in the water-contact group was comparable to a historical control group with a 0.6% infection rate, although the difference was not statistically significant.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Postoperative wound healing in wound-water contact]. Köninger, J., Russ, M., Schmidt, R., et al.[2013]

A systematic review and meta-analysis of 12 studies involving 2,839 patients found no significant difference in infection or complication rates between patients who showered within the first 48 hours after surgery and those who showered later.

Allowing early postoperative showering does not increase the risk of wound infections or complications, suggesting that patient satisfaction can be improved without compromising safety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Does the timing of postoperative showering impact infection rates? A systematic review and meta-analysis. Copeland-Halperin, LR., Reategui Via Y Rada, ML., Levy, J., et al.[2020]

In a study of 569 patients undergoing prosthesis-based breast reconstruction, the duration of drain placement was found to significantly impact infection rates, with a 76.2% increase in infection risk for each additional week the drain was retained beyond 21 days.

The study concluded that drains should ideally be removed no later than 3 weeks post-surgery, and can be safely removed as early as 7 days post-operation, regardless of daily drainage volumes exceeding 30 mL.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Risk of infection is associated more with drain duration than daily drainage volume in prosthesis-based breast reconstruction: A cohort study. Chen, CF., Lin, SF., Hung, CF., et al.[2022]

In a study of 51 patients who underwent median sternotomy, those who showered within 48-72 hours post-surgery had a significantly lower rate of sternal wound infections (7.7%) compared to those who did not shower (32.0%).

Patients who showered reported less pain and higher levels of comfort and satisfaction, indicating that early post-operative showering can improve overall recovery experience.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effects of showering in 48-72 h after coronary artery bypass graft surgery through median sternotomy on wound infection, pain, comfort, and satisfaction: randomized controlled trial. Gök, F., Demir Korkmaz, F., Emrecan, B.[2022]

A study of 100 cardiac surgery patients found that early postoperative showers, initiated an average of 6 days after surgery, did not lead to any wound complications such as infections or dehiscence.

Patient satisfaction was high, with an average score of 7.4 out of 10, suggesting that early showers are well-received and can be safely implemented after cardiac surgery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of early postoperative shower after cardiac surgery. Yoo, JS., Lee, H., Kim, SE., et al.[2022]

A systematic review identified only one high-risk bias trial involving 857 patients that compared early post-operative bathing (within 12 hours) to delayed bathing (after 48 hours), finding no significant difference in surgical site infections (SSIs) between the two groups (8.5% vs 8.8%).

Due to the lack of conclusive evidence and the wide confidence intervals, the study suggests that further randomized controlled trials are needed to better understand the impact of early versus delayed post-operative bathing on wound healing and complications.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Early versus delayed post-operative bathing or showering to prevent wound complications. Toon, CD., Sinha, S., Davidson, BR., et al.[2021]

In a study of 187 breast cancer patients, the 20 mL drain removal strategy resulted in the best balance of drain duration and quality of life, particularly in physical and role functioning at 2 and 3 weeks post-surgery.

The 20 mL group had a lower incidence of seroma compared to the 30 mL group, suggesting that this strategy may reduce complications while maintaining similar healthcare costs and postoperative outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

What Is the Optimal Strategy for Drain Removal After Mastectomy and Axillary Surgery in Breast Cancer Patients? A Multicenter, Three-Arm Randomized Clinical Trial. Wen, N., Ouyang, C., Hu, X., et al.[2022]

A study involving 30 patients who underwent breast reconstruction with DIEP flaps found that postoperative showering is safe for patients with closed suction drainage, as it did not increase complications such as infections.

Patients were allowed to shower when they had two or fewer drainage tubes, and no significant differences in complications were observed among those with different numbers of drains, indicating that early showering can be safely incorporated into postoperative care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Postoperative Showering for Patients With Closed Suction Drainage: A Retrospective Cohort Study of Deep Inferior Epigastric Perforator Flap Breast Reconstructions. Ogawa, H., Tahara, S.[2022]

In a study of 149 patients undergoing microvascular breast reconstruction, the average duration for breast and abdominal drains was found to be 12.9 days and 17.7 days, respectively, with prolonged use defined as beyond 14 days for breast drains and 19 days for abdominal drains.

Factors such as elevated BMI, hypertension, axillary dissection, and certain racial backgrounds (African-American and Hispanic) were associated with longer breast drain durations, highlighting the need for tailored post-operative care for these patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Predictors for Prolonged Drain Use Following Autologous Breast Reconstruction. Dinis, J., Allam, O., Junn, A., et al.[2022]

Citations

1. withpower.com withpower.com/trial/phase-infections-2-2023-32c54

Early Showering After Surgery for Breast Reconstruction ... Research shows that early showering after surgery, even with drains, is safe and does not increase the risk of complications like infections. Patients who ...

2. apm.amegroups.org apm.amegroups.org/article/view/98134/html

Elective surgery and postoperative shower: mind the gap and ... In the absence of relevant evidence, the empirical recommendation for showering varies from 48 hours to 2 weeks after the operation. During the last years, a ...

3. mdpi.com mdpi.com/2077-0383/13/21/6586

Optimal Use of Drain Tubes for DIEP Flap Breast ... Overall, their findings support the safety of early postoperative showering for patients with CSDs [4]. However, further studies are needed to ...

4. researchgate.net researchgate.net/publication/396553873_Safety_and_efficacy_of_early_drain_removal_in_breast_reconstruction_a_retrospective_cohort_study

"Safety and efficacy of early drain removal in breast ... "Safety and efficacy of early drain removal in breast reconstruction: a retrospective cohort study". October 2025; Breast Cancer. DOI:10.1007/ ...

5. directivepublications.org directivepublications.org/aips/articles/A-Comprehensive-Review-of-the-Best-Use-of-Drain-Tubes-for-DIEP-Flap-Breast-Reconstruction.pdf

A Comprehensive Review of the Best Use of Drain Tubes for ... Additionally, early postoperative showering may improve patient comfort. With an emphasis on the placement, duration, and removal criteria in relation to DIEP ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12465920/

Safety of early postoperative showering in level-1 and ... Letting patients shower 24 h after plastic surgery appears to be safe for those with low-risk wounds. This finding may help improve comfort and ...

7. cdn.clinicaltrials.gov cdn.clinicaltrials.gov/large-docs/38/NCT05846438/Prot_000.pdf

BIOMEDICAL RESEARCH PROTOCOL UNIVERSITY OF ... This study found that postoperative showering for patients with closed suction drainage is safe and does not increase the incidence of ...