To explore the role of closed suction drain in multi-level posterior spinal surgery. We performed prospective, open-label, randomised control, superiority trial with parallel design and 1:1 allocation. A total of 161 patients undergoing posterior spinal surgery involving more than one motion segment at a dedicated spine surgery department were randomly allocated into drain or no-drain groups, based on which surgical drain was employed at the end of surgery. After excluding six cases with intraoperative dural tear, the data of 80 patients in drain and 75 patients in no-drain group were analysed. Primary outcome was total perioperative blood loss (sum of intraoperative blood loss, volume of drain if present and volume aspirated if patient developed collection in relation to surgical wound). The secondary outcomes were transfusion requirements, wound healing and complications. Both groups were comparable with respect to baseline characteristics. Total perioperative blood loss was significantly higher in drain group (716 312.97 ml vs 377.9 295.72 ml, p0.0001). Number and volume of post-operative aspirations were significantly higher in no-drain group whereas transfusion requirements were significantly higher in drain group. Except for one case of superficial wound inflammation in either group, there were no complications. Subgroup analysis revealed that the results were applicable for surgeries involving two/three levels and more than three levels. The practice of not using closed surgical drains after multi-level posterior spinal surgery reduces post-operative blood loss and transfusion requirements. But this comes with the disadvantage of increased wound soakage and need for post-operative wound aspirations. The risks of benefits of drain and no drain must be carefully weighed and an informed choice be taken. These slides can be retrieved under Electronic Supplementary Material.
展开▼
机译：探讨闭合吸入排放在多级后脊柱手术中的作用。我们进行了前瞻性，开放标签，随机控制，优势试验，并行设计和1：1分配。总共161例患有在专用脊柱手术部门的多个运动段的后脊椎手术患者被随机分配到排水管或无排出基团中，基于手术结束时使用外科排水管。分析了术后术后术后撕裂的六种病例后，分析了80例患者的排水管和75例无排水组患者。主要结果是完全围手术期失血（如果患者发生与手术伤口相关的收集），则术中失血量的总和，如果患者发育收集）。二次结果是输血要求，伤口愈合和并发症。两组与基线特征相当。排水基团的总围路血液损失显着较高（716 312.97ml Vs 377.9 295.72ml，P <0.0001）。无排水基团的术后吸入的数量和体积显着高，而输血要求在排水基团明显高。除了任一组中的一种浅表伤口炎症之外，没有并发症。亚组分析表明，结果适用于涉及两个/三个层面和三个以上级别的手术。多级后脊椎手术后未使用闭合外科漏血的做法降低了术后失血和输血要求。但这具有增加伤口浸泡的缺点，并且需要术后伤口吹血。必须仔细称重流失的效益和无排水管的风险，并进行明智的选择。这些幻灯片可以在电子补充材料下检索。
展开▼
