Patient‐Directed Home Drain Removal in Head and Neck Surgery

Abstract

Objectives/Hypothesis The purpose of this study was to evaluate the efficacy and safety of at home drain removal in head and neck surgery patients. Methods The study population included patients who underwent head and neck surgery at an academic tertiary care center between February 2020 and November 2020 and were discharged with one to four drains with instructions for home removal. Prior to discharge, patients received thorough drain removal education. Patients were prospectively followed to evaluate for associated outcomes. Results One hundred patients were evaluated in the study. There was record for ninety‐seven patients receiving education at discharge. The most common methods of education were face‐to‐face education and written instructions with educational video link provided. Of 123 drains upon discharge, 110 drains (89.4%) were removed at home while 13 (10.6%) were removed in office. Most drains were located in the neck (86.4%). There was one seroma, two hematomas, two drain site infections, and five ED visits; however, none of these complications were directly associated with the action of drain removal at home. Calculated cost savings for travel and lost wages was $259.82 per round trip saved. Conclusions The results demonstrate that home drain removal can provide a safe and efficacious option for patients following head and neck surgery. This approach was safe and associated with patient cost savings and better utilization of provider's time. Furthermore, patients and healthcare providers avoided additional in‐person encounters and exposures during the COVID‐19 pandemic. Our findings warrant further investigation into cost savings and formal patient satisfaction associated with home drain removal. Level of Evidence 4 Laryngoscope, 131:2471–2477, 2021

Optimizing Surgical Care Amidst COVID-19: A Scoping Review of Practices and Policies

“…Almost 90% of drains that were successfully removed without major problems were located in the neck region. During the COVID-19 pandemic, it was discovered that the removal of home drains not only helped save money but also prevented potentially hazardous in-person encounters between patients and healthcare providers [ 71 ]. The feasibility and applicability of telemedicine in rhinology were investigated in a study conducted in Saudi Arabia.…”

“…Home drain removal successfully implemented for most neck surgeries, preventing hazardous in-person encounters while telemedicine managed rhinology cases effectively. [18,19,38,[69][70][71] Plastic…”

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“…Most surgical procedures have traditionally employed drains ( 23 , 24 ). It has been a standard procedure to drain wounds following thyroid and parathyroid surgery.…”

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“…Vorhandensein einer Redon- oder sonstigen Drainage, nach Vorabtrends und mündlichen Mitteilungen aus der Studie bei Parotidektomie ist das Nachblutungsrisiko nicht von der Anwendung einer (Redon-)Drainage abhängig 21 22 . Die Anwendung einer Drainage erfolgt typischerweise nach Vorselektion der Patienten und des Eingriffes durch den Operateur und signalisiert, dass mit zu drainierenden Nachblutungen gerechnet werden muss.…”