Background: Drains are used in plastic surgery to remove excess fluid while ameliorating complications. However, there is a paucity of evidence supporting guiding parameters on when to discontinue a drain. The aim of our study was to determine whether two of the most common parameters, drain volume 24 hours before removal or postoperative day, are valid indicators for drain removal. Methods: A retrospective chart review was conducted for surgical operations performed by our division between July 2014 and May 2019. Of the 1308 patients, 616 had a drain and a complete record. Demographics, medical history, operative time, antibiotic use, anatomic site, donor/recipient, and complication type were recorded. Complications were defined as events that deviated from expected postoperative course or required pharmacological/procedural intervention. T -test and Chi square were used to analyze data. Results: In total, 544 patients were in the no complication group, and 72 were in the complication group. The complication group patients had drains removed later than patients in the no complication group (15.7 days versus 12.5 days, P = 0.0003) and had similar final 24-hour drain volumes versus patients in the no complication group (16.7 mL versus 18.8 mL, P = 0.2548). The complication group had more operations on the pelvis (11% versus 2.1%; P = 0.000017) or thigh (8.5% versus 3.4%; P = 0.029). Conclusions: Our data suggest neither postoperative day nor 24-hour volume before drain removal are valid indicators for removal. Late removal correlates with more complications; however, persisting output leading to later removal may be predictive of an impending complication rather than delays in drain removal causing the complication.

No abstract

Background: Recurrent laryngeal nerve (RLN) injury carries significant morbidity. Microsurgical repair of the RLN has proven promising for enhancing patient recovery of vocal function; however, data remains limited. Methods: This retrospective cohort study included patients who underwent RLN repair from 2007 to 2022. Demographics and medical history were collected. The location and etiology of RLN injury, as well as the repair technique, were collected. Follow-up data was collected at the initial post-operative visit, at six months, and at one year. Hoarseness was classified as mild, moderate, or severe. Of patients who underwent nasopharyngolaryngoscopy (NPL) following repair, the glottic gap was measured. Vocal interventions performed were also recorded. This study utilized descriptive statistical methods. Results: Eleven patients underwent RLN repair. All patients underwent immediate repair. Fifty-four percent (N=6) of RLN injuries resulted from tumor inflammation or nerve encasament. Eighty-two percent (N=9) underwent direct RLN coaptation, 9% (N=1) underwent vagus-RLN anastomosis, and 9% (N=1) underwent an interposition nerve graft. Technical success was 100%. Seventy-three percent (N=8) required otolaryngology referral, and of those, 50% (N = 4) required intervention. At initial evaluation, 91% (N=10) suffered from mild to severe hoarseness, and of patients who underwent NPL, all had a glottic gap. At one year, 82% of patients (N=9) improved to having mild to no appreciable hoarseness. Of the patients who underwent NPL, 62% (N=5) had closure of the glottic gap. Conclusion: Patients undergoing repair of the RLN following injury showed excellent recovery of vocal function and resolution of glottic gap at one year

No abstract