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Evidence-based value of subcutaneous surgical wound drainage: the largest systematic review and meta-analysis.

Publication ,  Journal Article
Kosins, AM; Scholz, T; Cetinkaya, M; Evans, GRD
Published in: Plastic and reconstructive surgery
August 2013

The purpose of this study was to determine the evidenced-based value of prophylactic drainage of subcutaneous wounds in surgery.An electronic search was performed. Articles comparing subcutaneous prophylactic drainage with no drainage were identified and classified by level of evidence. If sufficient randomized controlled trials were included, a meta-analysis was performed using the random-effects model. Fifty-two randomized controlled trials were included in the meta-analysis, and subgroups were determined by specific surgical procedures or characteristics (cesarean delivery, abdominal wound, breast reduction, breast biopsy, femoral wound, axillary lymph node dissection, hip and knee arthroplasty, obesity, and clean-contaminated wound). Studies were compared for the following endpoints: hematoma, wound healing issues, seroma, abscess, and infection.Fifty-two studies with a total of 6930 operations were identified as suitable for this analysis. There were 3495 operations in the drain group and 3435 in the no-drain group. Prophylactic subcutaneous drainage offered a statistically significant advantage only for (1) prevention of hematomas in breast biopsy procedures and (2) prevention of seromas in axillary node dissections. In all other procedures studied, drainage did not offer an advantage.Many surgical operations can be performed safely without prophylactic drainage. Surgeons can consider omitting drains after cesarean section, breast reduction, abdominal wounds, femoral wounds, and hip and knee joint replacement. Furthermore, surgeons should consider not placing drains prophylactically in obese patients. However, drain placement following a surgical procedure is the surgeon's choice and can be based on multiple factors beyond the type of procedure being performed or the patient's body habitus.Therapeutic, II.

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Published In

Plastic and reconstructive surgery

DOI

EISSN

1529-4242

ISSN

0032-1052

Publication Date

August 2013

Volume

132

Issue

2

Start / End Page

443 / 450

Related Subject Headings

  • Wound Healing
  • Treatment Outcome
  • Surgical Wound Infection
  • Surgical Procedures, Operative
  • Surgery
  • Subcutaneous Tissue
  • Risk Assessment
  • Reference Values
  • Randomized Controlled Trials as Topic
  • Primary Prevention
 

Citation

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Kosins, A. M., Scholz, T., Cetinkaya, M., & Evans, G. R. D. (2013). Evidence-based value of subcutaneous surgical wound drainage: the largest systematic review and meta-analysis. Plastic and Reconstructive Surgery, 132(2), 443–450. https://doi.org/10.1097/prs.0b013e3182958945
Kosins, Aaron M., Thomas Scholz, Mine Cetinkaya, and Gregory R. D. Evans. “Evidence-based value of subcutaneous surgical wound drainage: the largest systematic review and meta-analysis.Plastic and Reconstructive Surgery 132, no. 2 (August 2013): 443–50. https://doi.org/10.1097/prs.0b013e3182958945.
Kosins AM, Scholz T, Cetinkaya M, Evans GRD. Evidence-based value of subcutaneous surgical wound drainage: the largest systematic review and meta-analysis. Plastic and reconstructive surgery. 2013 Aug;132(2):443–50.
Kosins, Aaron M., et al. “Evidence-based value of subcutaneous surgical wound drainage: the largest systematic review and meta-analysis.Plastic and Reconstructive Surgery, vol. 132, no. 2, Aug. 2013, pp. 443–50. Epmc, doi:10.1097/prs.0b013e3182958945.
Kosins AM, Scholz T, Cetinkaya M, Evans GRD. Evidence-based value of subcutaneous surgical wound drainage: the largest systematic review and meta-analysis. Plastic and reconstructive surgery. 2013 Aug;132(2):443–450.

Published In

Plastic and reconstructive surgery

DOI

EISSN

1529-4242

ISSN

0032-1052

Publication Date

August 2013

Volume

132

Issue

2

Start / End Page

443 / 450

Related Subject Headings

  • Wound Healing
  • Treatment Outcome
  • Surgical Wound Infection
  • Surgical Procedures, Operative
  • Surgery
  • Subcutaneous Tissue
  • Risk Assessment
  • Reference Values
  • Randomized Controlled Trials as Topic
  • Primary Prevention