The Drainage Dilemma in Thyroid Surgeries: A Randomized Controlled Trial to Evaluate Necessity of Drain Following...

Draining the thyroid bed after thyroid surgery is a matter of apprehension and anxiety for the operating surgeon rather than its necessity. This study aims to evaluate the evidence-based evaluation of the necessity of a drain following thyroidectomy.

A randomized-controlled trial was conducted at a tertiary care center in Central India for 2 years with a sample size of 80 patients undergoing thyroidectomy, with 40 patients in both thyroidectomy with drain and thyroidectomy without drain group each. The postoperative protocol and standard of care were similar in both groups. The patients were assessed for pain, seroma formation, and wound infection on postoperative day 1, 3, and 5, and patient-rated satisfaction scoring was done using a 5-point Likert scoring.

The age distribution in both the groups was comparable with a mean age of presentation in Group A was 42.1 ± 11.6 years and for Group B was 43.4 ± 14.2 years. Patients with a drain experienced significantly more pain (P < 0.00001) and increased length of hospital stay (P < 0.0001). The patients in the group without a drain were significantly more satisfied (significant P < 0.022). Only 4 patients in the group without a drain developed seroma. None of the patients had hematoma or surgical site infection in the postoperative period.

Drain placement after thyroid surgeries has no additional benefits in preventing postoperative risk of seroma/hematoma formation or occurrence of surgical site infection. Rather, the use of drains is usually associated with postoperative discomfort, increased length of hospital stays, and leaves an additional scar affecting overall esthetics for patients.