Long-term sequelae of patients with retained drains in spine surgery
Elizabeth B Gausden1, Andrew A Sama, Fadi Taher
1*Weill Cornell Medical College †Spine Surgery Service, Hospital for Special Surgery, New York, NY ‡Centrum fur Muskuloskeletale Chirurgie, Charite, Berlin, Germany.
Study Design:
Case series.
Objective:
To assess sequelae of retained surgical drains in patients undergoing spine surgery.
Summary Of Background Data:
Although a rare event, surgical drains may break either before or during removal attempts. In cases of retained surgical drains, the patient and surgeon are left with a decision of either surgically removing the drain fragment, or leaving it in situ. There is a paucity of literature that pertains to this unusual complication of spine surgery and its effect on long-term outcome.
Methods:
Cases of retained drain fragments that occurred at the spine service of a single institution between January 1, 1990 and December 31, 2008 were identified using the institutional electronic billing system, International Classification of Diseases and Related Health Problems-9 codes, and surgeons' records.
Results:
Seven cases of retained drains were identified to have occurred during the study period. Five of the patients underwent a subsequent operation for drain removal without complications, whereas 2 patients elected to leave the drain in situ. At a minimum of 2-year follow-up, neither of the patients in which the drain fragment had been left in situ reported complications or sequelae related to the drain fragment, and radiographic imaging showed no distinct migration of the fragment within the soft tissue.
Conclusions:
The 2 reported cases with a retained drain fragment left in situ support published and anecdotal opinions on retained soft-tissue drains not adversely affecting long-term patient outcome. In cases of asymptomatic patients with retained drains within soft tissue, leaving the fragment in situ is a treatment option that deserves consideration.
