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Drains for thyroidectomy/parathyroidectomy: fact or fiction?
M A Tabaqchali1, J M Hanson, G Proud
1Department of Surgery, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
Annals of the Royal College of Surgeons of England
|January 25, 2000
Summary
Routine neck drainage after thyroid and parathyroid surgery is unnecessary. Studies show routine drains increase infection risk and offer no benefit for bleeding or airway obstruction, suggesting selective use is preferable.
Area of Science:
- Endocrine Surgery
- Surgical Outcomes
- Evidence-Based Medicine
Background:
- Routine neck drainage after thyroid and parathyroid surgery is a common practice, despite a lack of supporting scientific evidence.
- The value of routine drain use in these procedures has been questioned.
Purpose of the Study:
- To evaluate the necessity and impact of routine versus selective neck drainage following thyroidectomy and parathyroidectomy.
Main Methods:
- A retrospective review of 606 thyroidectomy and parathyroidectomy procedures performed over 14 years by a single endocrine surgeon.
- Patients were divided into two groups: routine drain use (first 6 years) and selective drain use (subsequent 8 years).
Main Results:
- Routine drain use was associated with a significant increase in postoperative bleeding/hematoma (P < 0.05).
- Wound infections occurred exclusively in patients who had drains inserted.
- No significant difference was observed in the incidence of postoperative bleeding or airway obstruction between the groups.
Conclusions:
- Routine neck drainage after thyroid and parathyroid surgery is not supported by evidence and may be harmful.
- Selective use of drains, based on operative findings, is recommended to minimize complications such as wound infection.