suction_drain

Placement of a drain during anterior cervicotomy for (ACDF/ACDR) did not limit the occurrence of symptomatic postoperative hematoma 1).

see also Jackson Pratt drain.

Wound suction drains have been used to decrease the rate of postoperative hematoma formation and thus wound infections for many years throughout all surgical subspecialties. Although the use of surgical drains dates back to the years of Hippocrates 2) , in the orthopedic literature these drains have not been shown to be beneficial in decreasing the rates of these complications, especially in orthopedic procedures including fracture fixation or arthroplasty surgeries. 3) 4) 5) 6) However, these drains are still commonly used throughout the orthopedic community, including spine surgery.

In spine surgery, the controversy of suction drains are profound because it decreases the rare but devastating complication of postoperative spinal epidural hematoma, but it may have a hypothetical increase in the risk of infection 7) 8).


1)
Aggad M, Terrier LM, Nidal Salah C, Zemmoura I, Planty-Bonjour A, Francois P, Amelot A. Are there Still any Benefits to Drainage for Anterior Cervical Arthrodesis/Arthroplasty by Cervicotomy? Spine (Phila Pa 1976). 2024 Feb 16. doi: 10.1097/BRS.0000000000004964. Epub ahead of print. PMID: 38362711.
2)
Hippocrates The Genuine Works of Hippocrates Baltimore, MD: Williams & Wilkins; 1939
3)
Joshy S, Tharian B. Wound drainage versus non-drainage for proximal femoral fractures. A prospective randomised study. Injury. 2006;37(1):85.
4)
Lang G J, Richardson M, Bosse M J. et al. Efficacy of surgical wound drainage in orthopaedic trauma patients: a randomized prospective trial. J Orthop Trauma. 1998;12(5):348–350.
5)
Parker M J, Roberts C P, Hay D. Closed suction drainage for hip and knee arthroplasty. A meta-analysis. J Bone Joint Surg Am. 2004;86-A(6):1146–1152.
6)
Ritter M A, Keating E M, Faris P M. Closed wound drainage in total hip or total knee replacement. A prospective, randomized study. J Bone Joint Surg Am. 1994;76(1):35–38.
7)
Parker M J, Livingstone V, Clifton R, McKee A. Closed suction surgical wound drainage after orthopaedic surgery. Cochrane Database Syst Rev. 2007;(3):CD001825.
8)
Payne D H, Fischgrund J S, Herkowitz H N, Barry R L, Kurz L T, Montgomery D M. Efficacy of closed wound suction drainage after single-level lumbar laminectomy. J Spinal Disord. 1996;9(5):401–403.
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