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2015 ; 5
(6
): 479-85
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gab.com Text
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English Wikipedia
The Outcome of Using Closed Suction Wound Drains in Patients Undergoing Lumbar
Spine Surgery: A Systematic Review
#MMPMID26682098
Waly F
; Alzahrani MM
; Abduljabbar FH
; Landry T
; Ouellet J
; Moran K
; Dettori JR
Global Spine J
2015[Dec]; 5
(6
): 479-85
PMID26682098
show ga
Study Design?Systematic review. Objective?Determine whether closed suction wound
drains decrease the incidence of postoperative complications compared with no
drain use in patients undergoing spine surgery for lumbar degenerative
conditions. Methods?Electronic databases and reference lists of key articles were
searched up through January 22, 2015, to identify studies comparing the use of
closed suction wound drains with no drains in spine surgery for lumbar
degenerative conditions. Outcomes assessed included the cumulative incidence of
epidural hematoma, superficial and deep wound infection, and postoperative blood
transfusion. The overall strength of evidence across studies was based on
precepts outlined by the Grades of Recommendation Assessment, Development and
Evaluation Working Group. Results?Five heterogeneous studies, three randomized
controlled trials, and two cohort studies form the evidence basis for this
report. There was no difference in the incidence of hematoma, superficial wound
infection, or deep infection in patients with compared with patients without
closed suction wound drains after lumbar surgery. The upper bounds of the 95%
confidence interval for hematoma ranged from 1.1 to 16.7%; for superficial
infection, 1.0 to 7.3%; and for deep infection, 1.0 to 7.1%. One observational
study reported a 3.5-fold increase in the risk of blood transfusion in patients
with a drain. The overall strength of evidence for these findings is considered
low or insufficient. Conclusions?Conclusions from this systematic review are
limited by the quality of included studies that assessed the use of closed
suction wound drains in lumbar spine surgeries for degenerative conditions. We
believe that spine surgeons should not routinely rely on closed suction wound
drains in lumbar spine surgery until a higher level of evidence becomes available
to support its use.