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To drain or not drain: literature versus practice
A Chandratreya1, K Giannikas, P Livesley
1King's Mill Centre, Sutton-in-Ashfield, Nottinghamshire.
Journal of the Royal College of Surgeons of Edinburgh
|February 17, 1999
Summary
Most orthopaedic surgeons routinely use closed suction drains despite evidence showing no significant benefit for wound healing or infection rates. This practice deviates from evidence-based medicine in routine orthopaedic procedures.
Area of Science:
- Orthopaedic Surgery
- Surgical Drainage
- Evidence-Based Medicine
Background:
- Recent literature indicates no significant difference in outcomes (wound healing, infection, hospitalization) between drained and undrained groups in routine orthopaedic procedures.
- Despite this evidence, the use of closed suction drains remains prevalent in clinical practice.
Purpose of the Study:
- To assess the current utilization and perceptions of closed suction drains in orthopaedic surgery.
- To determine the extent to which current practices align with published scientific evidence.
Main Methods:
- A comprehensive literature review was performed.
- Two surveys were conducted: a questionnaire to British Orthopaedic Association members and interviews with orthopaedic consultants in the Mid-Trent Region.
Main Results:
- Both surveys revealed that closed suction drains are routinely employed by the majority of orthopaedic surgeons.
- Surgeons' practices often continue irrespective of the available scientific literature on wound drainage.
Conclusions:
- The findings suggest a disconnect between current orthopaedic surgical practices regarding wound drainage and evidence-based medicine in the United Kingdom.
- Further education and dissemination of research findings are needed to promote evidence-based decision-making in orthopaedic wound management.