Survey of the Use of Suction Drains in Head and Neck Surgery and Analysis of Their Biomechanical Properties

Williams, Jason; Toews, Daniel P.; Prince, Mark

doi:10.2310/7070.2003.35365

Cited by 35 publications

(29 citation statements)

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“…Williams et al 13 found that the amount of drainage that is collected in the drain reservoir is maximal in the first 24 h after insertion. Our study of 43 cases showed that the highest rate of drainage occurs in the first 8 h after operation and starts to decline significantly after this period.…”

Section: Discussionmentioning

confidence: 99%

Postoperative drainage in head and neck surgery

Amir

Morar

Belloso

2010

annals

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INTRODUCTION A major factor affecting patients’ length of hospitalisation following head and neck surgery remains the use of surgical drains. The optimal time to remove these drains has not been well defined. A routine practice is to measure the drainage every 24 h and remove the drain when daily drainage falls below 25 ml. This study aims to determine whether drainage measurement at shorter intervals decreases the time to drain removal and hence the length of in-patient stays. PATIENTS AND METHODS A 6-month prospective observational study was performed. The inclusion criteria were patients who underwent head and neck surgery without neck dissection and had a closed suction drain inserted. Drainage rates were measured at 8-hourly intervals. Drains were removed when drainage-rate was ≤ 1 ml/h over an 8-h period. RESULTS A total of 43 patients were evaluated. The highest drainage rate occurred in the first 8 postoperative hours and decreased significantly in the subsequent hours. The median drainage rates at 8, 16, 24, 32 and 40 postoperative hours were 3.375, 1, 0, 0 and 0 ml/h, respectively. Applying our new removal criteria of ≤ 1 ml/h drainage rate, the drains were removed in 22 (51%) patients at the 16th postoperative hour; 37 (86%) were removed by 24 h after operation. In comparison, only nine (20.9%) patients could potentially be discharged the day after surgery if previous criteria of ≤ 25 ml/24-h were used to decide on drain removal. CONCLUSIONS Our 8-hourly drainage-rate monitoring has facilitated safe earlier discharge of an additional 28 (65%) patients on the day after surgery. This has led to improvement in patient care, better optimisation of hospital resources and resulted in positive economic implications to the department.

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Section: Discussionmentioning

confidence: 99%

Postoperative drainage in head and neck surgery

Amir

Morar

Belloso

2010

annals

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“…The most common complications after neck dissection are seroma and wound infection [3,4]. Therefore, head and neck surgeons routinely place a drainage tube after head and neck operations to reduce hematoma or seroma formation [5]. The drains typically comprise a closed vacuum system that takes away any excess blood or tissue fluid and facilitates the healing of the skin flaps.…”

Section: Introductionmentioning

confidence: 99%

The impact of tissue glue in wound healing of head and neck patients undergoing neck dissection

Huang

Wang

Jiang

et al. 2015

Eur Arch Otorhinolaryngol

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We investigated the impact of fibrin glue on postoperative drainage amount and duration in head and neck cancer patients who underwent neck dissection. This study was a prospective randomized controlled trial. Patients who were scheduled to undergo neck dissection due to head and neck cancer were eligible for this study. After receiving a detailed explanation, all patients signed an informed consent form before enrollment. Patients were then randomly assigned to the study group (fibrin glue) or control group. In the study group, 2 ml of fibrin glue (Tissucol(®); Duploject, Baxter AG) was applied on the surface of the surgical wound before closure. Basic demographic data along with tumor-related features, operation-related variables, postoperative drainage amount/duration, postoperative pain, and analgesic usage were collected and analyzed. A total of 15 patients were included in the final analyses, with eight patients in the study group and seven patients in the control group. No significant differences were found between the two groups in age, gender, primary site, clinical N stage, neck dissection levels, perioperative bleeding, postoperative drainage amount/duration, hospitalization duration, and postoperative pain status. The application of 2 ml fibrin glue by the method described herein did not reduce the postoperative drainage amount/duration nor the postoperative pain status in patients who underwent neck dissection.

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“…While some authors have recommended the routine use of drainage after thyroidectomy for the above stated reasons [1][2][3][4][5], this recommendation has been debated extensively in the literature [6][7][8][9][10][11]. Ruark and AbdelMisih [6] reviewed retrospectively 110 thyroid operations without drainage, without encountering a single instance of acute hematoma, nor did Ariyanayagam et al [7] in a retrospective review of 260 thyroid procedures performed without drainage.…”

Section: Basis Of the Analysismentioning

confidence: 99%

“…In the past most surgeons employed wound drains routinely with the hope of decreasing the risk of acute airway obstruction by hematoma as well as postoperative hematoma or seroma [1][2][3][4][5]. Several authors, however, have suggested that use of drains could increase the risk of infection, the length of hospital stay, treatment costs, and discomfort for the patient.…”

Section: Introductionmentioning

confidence: 99%

Routine drainage after thyroid surgery—A meta‐analysis

Sanábria

Carvalho

Silver

et al. 2007

Journal of Surgical Oncology

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Thyroidectomy is a common surgical procedure. The results of some clinical trials suggest that routine drainage does not offer advantages, but the evidence is not strong either in favor of or against this intervention. The effect of routine drainage compared to no drainage in patients subject to thyroidectomy was measured using a meta-analysis. After an extensive literature review, suitable randomized clinical trials were selected for analysis. Outcome measures included the comparative incidence of neck hematoma or seroma and length of hospital stay. Eleven randomized clinical trials were included. There were no statistically significant differences in the incidence of neck hematoma/seroma (OR 1.03, 95% CI 0.59-1.81) between the groups. The mean length of hospital stay was 1.53 days longer for the drainage group (95% CI 1.39-1.68). There was no difference found between routine drainage and no drainage with regard to the frequency of postoperative hematoma/seroma in patients following thyroidectomy. In addition, the mean length of hospital stay was longer in the routine drainage group.

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Survey of the Use of Suction Drains in Head and Neck Surgery and Analysis of Their Biomechanical Properties

Cited by 35 publications

References 0 publications

Postoperative drainage in head and neck surgery

Postoperative drainage in head and neck surgery

The impact of tissue glue in wound healing of head and neck patients undergoing neck dissection

Routine drainage after thyroid surgery—A meta‐analysis

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