'No Drain' Strategy for Post-operative Orthopaedic Cases

Background Post-operative wound management plays an important role in orthopaedic recovery. Closed-suction drains are commonly used to reduce wound collection, hematoma, seroma, and tension; however, their routine use remains debatable due to concerns about increased blood loss, transfusion requirements, discomfort, prolonged hospital stay, infection risk, cost, and additional drain-site scarring. Aim To evaluate the results of the 'No Drain' strategy in post-operative orthopaedic cases. Materials and methods This prospective observational study was conducted from September 2024 to April 2026 after ethical approval. A total of 114 patients undergoing clean orthopaedic surgeries were divided equally into Group A and Group B, with 57 patients in each group. Group A was managed without a drain, while Group B was managed with a closed negative suction drain. The study included arthroplasty, trauma, spine, and arthroscopy procedures. Outcomes assessed included post-operative hemoglobin drop, packed cell volume (PCV) transfusion requirement, hospital stay, complications, Visual Analogue Scale score (VAS), Stony Brook Scar Evaluation Scale score (SBSES), and drain-related cost. Results Group A had significantly lower post-operative hemoglobin drop than Group B (1.40 ± 0.69 g/dL vs 1.91 ± 0.80 g/dL; p < 0.001) and lower PCV transfusion requirement (0.72 ± 0.80 vs 1.18 ± 1.04 units; p = 0.010). Hospital stay was shorter in Group A (3.00 ± 0.00 vs 4.49 ± 1.70 days; p < 0.001). Complications were fewer in Group A (3.5% vs 17.5%; p = 0.015). Group A also showed a better VAS score (2.42 ± 1.12 vs 4.12 ± 1.56; p < 0.001) and SBSES score (3.88 ± 0.89 vs 2.89 ± 0.94; p < 0.001). Conclusion The 'No Drain' strategy is safe, effective, patient-friendly, and cost-saving in clean post-operative orthopaedic cases. Routine drains should be used selectively.