Wound drainage for lower limb arterial surgery

Area of Science:

• Vascular Surgery
• Wound Management
• Clinical Trials

Background:

• Drains are commonly used in leg wounds post-vascular surgery to manage fluid collections.
• The actual benefits and risks of drains, including infection and prolonged hospitalization, are uncertain.
• Surgeons require robust data on drain effects following lower limb arterial surgery.

Purpose of the Study:

• To determine if routine wound drains reduce complications after lower limb arterial surgery compared to no drains.

Main Methods:

• Systematic search of multiple databases (Cochrane Wounds, CENTRAL, MEDLINE, EMBASE, CINAHL) and trial registries up to June 2016.
• Inclusion of randomized controlled trials (RCTs) evaluating any drain type in lower limb arterial surgery.
• Independent data extraction and bias assessment by two authors; planned meta-analysis if clinically and statistically homogeneous.

Main Results:

• Three RCTs with 222 participants (333 wounds) were identified; all compared suction drainage to no drainage.
• All studies were assessed as high risk of bias, yielding very low-quality evidence.
• No significant difference in surgical site infections (SSI) between drained and non-drained wounds (RR 1.33; 95% CI 0.30-5.94) due to limited data and high risk of bias.

Conclusions:

• Limited, biased data prevents definitive conclusions on drain efficacy in lower limb arterial surgery.
• Uncertainty persists regarding benefits and harms due to small study numbers and methodological weaknesses.
• Higher quality evidence is needed; no active trials were identified.