Comparison Between Subcutaneous Closed-suction Drainage and Conventional Closed-suction Drainage in Adolescents Idiopathic Scoliosis Patients Undergoing Posterior Instrumented Spinal Fusion

Liang, Jinqian; Qiu, Guixing; Chua, Sooyong; Shen, Jianxiong

doi:10.1097/bsd.0b013e3182400897

Cited by 14 publications

(11 citation statements)

References 15 publications

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“…Diab et al 60 evaluated closed suction drainage in patients undergoing posterior fusion for idiopathic scoliosis and similarly found no difference in SSI rate or other complications in patients receiving drains versus no drains, with a higher transfusion rate in the drained group. In a randomized trial, Liang et al 61 evaluated the efficacy of subcutaneous closed-suction drains versus conventional drains following scoliosis surgery and found that subcutaneous closed-suction drainage offer a reasonable alternative to conventional deep drains. Although the use of drains is controversial, these studies did not find an increase in SSI rate with the use of surgical drains.…”

Section: Surgeon Factorsmentioning

confidence: 99%

Section: Closed Suction Drainsmentioning

confidence: 99%

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Surgical Site Infection Prevention Following Spine Surgery

Aleem

Tan

Nassr

et al. 2020

Global Spine Journal

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Study Design: Literature review. Objectives: Surgical site infection (SSI) following spine surgery leads to significant patient morbidity, mortality, and increased health care costs. The purpose of this article is to identify risk factors and strategies to prevent SSIs following spine surgery, with particular focus on avoiding infections in posterior cervical surgery. Methods: We performed a literature review and synthesis to identify methods that can be used to prevent the development of SSI following spine surgery. Specific pearls for preventing infection in posterior cervical spine surgery are also presented. Results: SSI prevention can be divided into patient and surgeon factors. Preoperative patient factors include smoking cessation, tight glycemic control, weight loss, and nutrition optimization. Surgeon factors include screening and treatment for pathologic microorganisms, skin preparation using chlorhexidine and alcohol, antimicrobial prophylaxis, hand hygiene, meticulous surgical technique, frequent irrigation, intrawound vancomycin powder, meticulous multilayered closure, and use of closed suction drains. Conclusion: Prevention of SSI following spine surgery is multifactorial and begins with careful patient selection, preoperative optimization, and meticulous attention to numerous surgical factors. With careful attention to various patient and surgeon factors, it is possible to significantly reduce SSI rates following spine surgery.

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Section: Surgeon Factorsmentioning

confidence: 99%

Section: Closed Suction Drainsmentioning

confidence: 99%

Surgical Site Infection Prevention Following Spine Surgery

Aleem

Tan

Nassr

et al. 2020

Global Spine Journal

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“…Liang et al performed a prospective, randomised controlled clinical study to evaluate the efficacy of subcutaneous closed-suction drainage in comparison with conventional closed-suction drainage [16]. A total of 105 patients undergoing posterior instrumented spinal fusion due to adolescent idiopathic scoliosis were randomised into one of the two groups.…”

Section: Subfascial Versus Subcutaneous Drainagementioning

confidence: 99%

“…All other measurements showed no differences between groups. Liang et al included 105 patients and compared subcutaneous versus conventional closed-wound suction drainage systems [16]. The core temperature was higher (p = 0.001) and the duration of fever was longer (p = 0.008) in the subcutaneous drainage group.…”

Section: Postoperative Fevermentioning

confidence: 99%

Closed-suction drainage in thoracolumbar spinal surgery–clinical routine without evidence? a systematic review

Schnake

Pumberger

Rapper³

et al. 2022

Eur Spine J

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Purpose The considered benefit of surgical drain use after spinal surgery is to prevent local accumulation of a haematoma by decompressing the closed space in the approach of the surgical site. In this context, the aim of the present systematic review was to prove the benefit of the routine use of closed-suction drains. Methods We conducted a comprehensive systematic review of the literature according to the Preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist and algorithm. Results Following the literature search, 401 potentially eligible investigations were identified. Eventually, a total of 24 studies with 8579 participants were included. Negative suction drainage led to a significantly higher volume of drainage fluid. Drainage duration longer than 72 h may be associated with a higher incidence of Surgical side infections (SSI); however, accompanying antibiotic treatment is unnecessary. Regarding postoperative haematoma and neurological complications, no evidence exists concerning their prevention. Hospital stay length and related costs may be elevated in patients with drainage but appear to depend on surgery type. Conclusions With regard to the existing literature, the use of closed-suction drainage in elective thoracolumbar spinal surgery is not associated with any proven benefit for patients and cannot decrease postoperative complications.

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“…Typically, the discharge hemoglobin after surgery for spinal deformity has been reported to be approximately 10 g/dL. 85,86 Edwards et al 87 conducted a retrospective chart review of 475 patients at a single institution on multiple specialty services. They found that discharge hemoglobin was a significant indicator of overutilization of blood transfusion and that a large portion of patients who had discharge hemoglobin of 10.0 g/dL or more could have avoided at least 1 unit of blood transfusion.…”

Section: Indications To Transfusementioning

confidence: 99%

Management of operative blood loss in spinal deformity surgery

Gandhi

Verma

Aguwa

et al. 2015

Current Orthopaedic Practice

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Background:Surgery for spinal deformity is associated with high levels of blood loss that may be increased with certain patient factors and complex or revision procedures that include osteotomies. Major blood loss is a vital consideration in patients undergoing complex spine surgery not only because of direct hemodynamic consequences but also because of the potential complications associated with allogeneic blood administration. The purpose of this review is to describe the current evidence supporting blood conservation techniques in spinal deformity surgery.

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Comparison Between Subcutaneous Closed-suction Drainage and Conventional Closed-suction Drainage in Adolescents Idiopathic Scoliosis Patients Undergoing Posterior Instrumented Spinal Fusion

Abstract: The data suggest that subcutaneous closed-suction drainage offers a reasonable alternative to closed-wound suction drainage in adolescents idiopathic scoliosis patients undergoing posterior instrumented spinal fusion.

Cited by 14 publications

References 15 publications

Surgical Site Infection Prevention Following Spine Surgery

Surgical Site Infection Prevention Following Spine Surgery

Closed-suction drainage in thoracolumbar spinal surgery–clinical routine without evidence? a systematic review

Management of operative blood loss in spinal deformity surgery

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