The Use of Closed Suction Drainage in Lumbar Spinal Surgery: Is It Really Necessary?

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• 作者：Jia-Ming Liu¹ ; Wen-Zhao Chen¹ ; Bi-Qi Fu² ; Jiang-Wei Chen¹ ; Zhi-Li Liu¹ ; ^{liuzhiliyfy@163.com" class="auth_mail" title="E-mail the corresponding author} ; Shan-Hu Huang¹
• 关键词：Closed suction drainage ; Lumbar spine ; Meta-analysis ; Wound
• 刊名：World Neurosurgery
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：90
• 期：Complete
• 页码：109-115
• 全文大小：3174 K

文摘

Closed wound suction drainage after spine surgery is commonly used in clinical practice. However, no consensus has been reached for using drainage versus nondrainage after lumbar spinal surgery until now.

Objective

The purpose of this study was to determine the clinical outcomes of using closed suction drainage versus nondrainage after lumbar spinal surgery.

Methods

We conducted a systematic review and meta-analysis to identify relevant studies from PubMed, MEDLINE, EMBASE, Cochrane Library, and Google scholar up to September 2015. All randomized, quasi-randomized, and controlled clinical studies, which compared the clinical outcomes of using closed suction drainage versus nondrainage in patients who underwent lumbar spinal surgery, were included. Data extraction and quality assessment were according to Cochrane Collaboration guidelines.

Results

Five studies involving 1295 patients were included in this meta-analysis. By pooling the clinical outcomes, there were no significant differences between patients with drainage and nondrainage in terms of the incidence of wound infection (odds ratio [OR], 1.48; 95% confidence interval [CI], 0.47–4.71; P = 0.50), wound hematoma (OR, 0.45; 95% CI, 0.01–29.31, P = 0.71), and reoperation (OR, 1.36; 95% CI, 0.22–8.27; P = 0.74). Drainage after lumbar surgery was associated with more blood loss and significantly greater blood transfusions (OR, 3.68; 95% CI, 1.80–7.54; P < 0.01) compared with nondrainage. However, more patients contracted postoperative fever in the nondrainage group than did those in drainage group.

Conclusions

Based on this systematic review and meta-analysis, there is insufficient evidence to suggest routine use of prophylactic closed suction drainage after lumbar spinal surgery. However, a decision to use or not use drainage should be individualized for each patient because many factors affect the outcomes.