Closed suction surgical wound drainage after orthopaedic surgery

Parker, MJ; Roberts, C.P.

doi:10.1002/14651858.cd001825

Cited by 91 publications

(96 citation statements)

References 19 publications

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“…As could be expected, hospital stay for the index fracture was longer in patients with a wound infection. In the literature on drain placement in surgery of the musculoskeletal system no significant differences were found in incidence of wound infections, dehiscence or re-operation [27]. Unfortunately no specific data on calcaneal fracture surgery were available in this study.…”

Section: Discussionmentioning

confidence: 70%

Wound infections following open reduction and internal fixation of calcaneal fractures with an extended lateral approach

Backes

Schepers

Beerekamp

et al. 2013

International Orthopaedics (SICOT)

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Purpose Post-operative wound infections (PWI) following calcaneal fracture surgery can lead to prolonged hospital stay and additional treatment with antibiotics, surgical debridement or implant removal. Our aim was to determine the incidence of superficial and deep PWI and to identify risk factors (RF). Methods This study is a retrospective case series. All consecutive patients from 2000 to 2010 with a closed unilateral calcaneal fracture treated with open reduction and internal fixation (ORIF) by an extended lateral approach were included. Patient, fracture, trauma and peri-operative characteristics were collected, including RF such as smoking, diabetes mellitus, time to operation, pre-operative in-or outpatient management and wound closure technique. The primary end point was a PWI as defined by the US Centers for Disease Control and Prevention. Results A total of 191 patients were included of which 47 patients (24.6 %) had a PWI; 21 (11.0 %) and 26 (13.6 %) patients had a superficial and deep wound infection, respectively. American Society of Anesthesiologists (ASA) classification higher than ASA 1 was associated with an increased risk. Placement of a closed suction drain at the end of surgery was associated with less PWI (35 % vs 15 %, p =0.002). In this study, none of the previously reported RF were associated with an increased risk for PWI. Conclusions ORIF of displaced calcaneal fractures is associated with a high rate of PWI of 25 %. Factors that were associated with an increased risk were ASA classification other than 1 and absence of a closed suction drain placement.A closed suction drain may be a protective measure to avoid wound complications.

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Section: Discussionmentioning

confidence: 70%

Wound infections following open reduction and internal fixation of calcaneal fractures with an extended lateral approach

Backes

Schepers

Beerekamp

et al. 2013

International Orthopaedics (SICOT)

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“…It is unlikely, however not impossible, that this drainage may have affected the impact of topically applied fibrinogen. It should also be noted that blood transfusions are required more frequently in TKA patients that received drains [12]. Third, measuring blood loss in a controlled clinical trial environment is a complex science, which is prone to multifactorial bias such as the hydration status of the patient undergoing hypotensive anesthesia that we tried to cope with performing a randomized trial.…”

Section: Discussionmentioning

confidence: 99%

Intraarticular Fibrinogen Does Not Reduce Blood Loss in TKA: A Randomized Clinical Trial

Heyse

Haas

Drinkwater

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Bleeding remains an ongoing concern after total knee arthroplasty (TKA). Intraarticular application of human fibrinogen with a topical thrombin has been described to stop diffuse bleeding in knee arthroplasty. Questions/purposes It was hypothesized that the use of human fibrinogen as a topical agent would result in a reduction of bleeding and transfusions required after TKA; secondary end points included comparison of early clinical results including pain scores and range of motion (ROM) at 6 weeks and complications after surgery.

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“…We commonly use a postoperative drain but routinely remove it on postoperative day number one. In a meta-analysis of 5697 major orthopedic procedures, Parker et al [6,7] showed no difference in rates of infection, hematoma formation, or reoperations for wound complications with the use of a postoperative drain. In a prospective cohort study, Sorensen et al [11] evaluated drain tips in 489 orthopedic procedures including hip and knee arthroplasties and hip fractures.…”

Section: Discussionmentioning

confidence: 99%

Infection Associated With Hematoma Formation After Shoulder Arthroplasty

Cheung

Sperling

Cofield

2008

Clinical Orthopaedics &Amp; Related Research

131

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Hematoma formation requiring operative treatment after shoulder arthroplasty may be associated with higher patient morbidity. We therefore determined whether there was an association of hematoma formation requiring operative treatment with deep infection after shoulder arthroplasty. Between 1978 and 2006, we performed 4147 shoulder arthroplasties in 3643 patients. Of these, 12 shoulders (0.3%) underwent reoperation for hematoma formation. The mean time interval from arthroplasty to surgery for the hematoma was 7 days (range, 0.5-31 days). Among nine cases in which cultures were taken, six had positive cultures; the organisms included Propionibacterium acnes in three, Staphylococcus epidermidis in one, Streptococcus species in one, and Staphylococcus epidermidis with Peptostreptococcus in one. The minimum followup was 12 months (mean, 68 months; range, 12 to 294 months

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Closed suction surgical wound drainage after orthopaedic surgery

Cited by 91 publications

References 19 publications

Wound infections following open reduction and internal fixation of calcaneal fractures with an extended lateral approach

Wound infections following open reduction and internal fixation of calcaneal fractures with an extended lateral approach

Intraarticular Fibrinogen Does Not Reduce Blood Loss in TKA: A Randomized Clinical Trial

Infection Associated With Hematoma Formation After Shoulder Arthroplasty

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