PMID- 35481318
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220430
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 14
IP  - 3
DP  - 2022 Mar
TI  - Effect of Drain Output on the Timing of Closed Suction Drain (CSD) Removal After 
      Head and Neck Surgery.
PG  - e23391
LID - 10.7759/cureus.23391 [doi]
LID - e23391
AB  - BACKGROUND: A closed suction drain (CSD) is often utilized in head and neck 
      surgical procedures to obliterate dead space. CSDs reduce seroma and hematoma 
      formation, thereby improving skin apposition and wound healing. The use of drains 
      for prolonged periods of time, however, may increase the risk of wound infection. 
      Interestingly, the evidence regarding the need for, and management of, 
      post-operative CSDs after head and neck surgery is scarce. The current criterion 
      of drain removal when output is less than 30 cubic centimeters (cm(3)) within a 
      24-hour period and/or on the third post-operative day (POD) is widely utilized. 
      The aforementioned criterion is based on anecdotal evidence from small studies 
      with specific surgical procedures. In this study, we aim to evaluate the criteria 
      for drain removal and to lay the groundwork for an updated paradigm for drain 
      management in head and neck oncologic surgery. STUDY DESIGN: Retrospective cohort 
      study Setting: Academic tertiary care hospital Methods: A retrospective study was 
      performed. Patients were included if they underwent head and neck surgery at the 
      University of Miami Hospital between January 1, 2019 and July 1, 2020 and had at 
      least one CSD. Volume of drain output on each POD was recorded until the day of 
      drain removal. The development of post-operative wound complications (i.e., 
      seroma, hematoma, infection/abscess, and dehiscence) was also recorded. RESULTS: 
      From our initial cohort of 302 patients, 145 patients met inclusion criteria. A 
      total of 10 patients developed a post-operative wound complication. Patients had 
      a mean age of 58.3 +/- 15.0 years. The median inter-quartile range (IQR) drain 
      output (cm(3)) on the day of CSD removal from patients who developed a wound 
      complication was similar (15; IQR, 5-37.5) when compared to those who did not 
      develop a wound complication (25; IQR, 10-30). This difference was not 
      statistically significant (p = 0.60). Additionally, the cohort who developed a 
      post-operative wound complication had their drain removed on an earlier POD (1; 
      IQR, 1-1 (Mean 1.2)) when compared to the cohort who did not develop any 
      complications (1; IQR, 1-1 (Mean 1.5)). This difference was also not 
      statistically significant (p = 0.48) . CONCLUSION: There is no association 
      between drain output (cm(3)) or day of CSD removal with the development of wound 
      complications. These results warrant further studies to prospectively evaluate 
      earlier CSD removal in head and neck surgery.
CI  - Copyright (c) 2022, Bohorquez et al.
FAU - Bohorquez, Dominique
AU  - Bohorquez D
AD  - Otolaryngology - Head and Neck Surgery, University of Miami Miller School of 
      Medicine, Miami, USA.
FAU - Pena, Stefanie
AU  - Pena S
AD  - Otolaryngology - Head and Neck Surgery, University of Miami Miller School of 
      Medicine, Miami, USA.
FAU - Weed, Donald
AU  - Weed D
AD  - Otolaryngology - Head and Neck Surgery, University of Miami Miller School of 
      Medicine, Miami, USA.
FAU - Ma, Ruixan
AU  - Ma R
AD  - Biostatistics, University of Miami Miller School of Medicine, Miami, USA.
FAU - Arnold, David J
AU  - Arnold DJ
AD  - Otolaryngology - Head and Neck Surgery, University of Miami Miller School of 
      Medicine, Miami, USA.
LA  - eng
PT  - Journal Article
DEP - 20220322
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC9033514
OTO - NOTNLM
OT  - closed suction drain
OT  - criterion
OT  - drain output
OT  - head and neck surgery
OT  - post-operative day
OT  - prolonged drain use
OT  - wound complications
COIS- The authors have declared that no competing interests exist.
EDAT- 2022/04/29 06:00
MHDA- 2022/04/29 06:01
PMCR- 2022/03/22
CRDT- 2022/04/28 06:38
PHST- 2022/03/21 00:00 [accepted]
PHST- 2022/04/28 06:38 [entrez]
PHST- 2022/04/29 06:00 [pubmed]
PHST- 2022/04/29 06:01 [medline]
PHST- 2022/03/22 00:00 [pmc-release]
AID - 10.7759/cureus.23391 [doi]
PST - epublish
SO  - Cureus. 2022 Mar 22;14(3):e23391. doi: 10.7759/cureus.23391. eCollection 2022 
      Mar.