How Long to Keep the Surgical Drains- Looking for Evidence

Abstract

Objective: Closed suction drainage is the standard of care for head and neck surgical wounds. The aim of study is to determine the effective duration of surgical drains in different types of Head and Neck procedures. Study design: Prospective randomized trial in a tertiary referral center. Methods: A total of 153 patients were divided into five groups. The study included patients with Head and Neck malignancies undergoing surgery. The patients in each group were assigned to two groups (Day 2 and Day 5) and drain output was measured. Results: The total drainage was found to be more in laryngectomy group followed by neck dissection group, then by primary lesion excision with neck dissection followed by thyroidectomy group and lowest in Parotidectomy group. It was found that maximum drainage occurred in first 24hours after surgery, with subsequent decrease in drainage volume in all the groups. Conclusion: It is safe to remove the surgical drain after 48hours of major Head and Neck surgery. There were minimum drain related side effects in patients who had their drain removed in 48hours. There was a positive correlation between intraoperative blood loss and postoperative drainage in all groups. The drainage fluid after Major Head and Neck surgery is transudative in nature.