Final 24-hour Drain Output and Postoperative Day Are Poor Indicators for Appropriate Drain Removal.

Autor:	Chua C; Division of Plastic and Reconstructive Surgery, University of California Davis, Sacramento, Calif., Bascone CM; Division of Plastic and Reconstructive Surgery, University of California Davis, Sacramento, Calif., Pereira C; Division of Plastic and Reconstructive Surgery, University of California Davis, Sacramento, Calif., Hai J; University of California Davis School of Medicine, Sacramento, Calif., Park J; University of California Davis School of Medicine, Sacramento, Calif., Hideshima K; University of California Davis School of Medicine, Sacramento, Calif., Bhatti S; University of California Davis School of Medicine, Sacramento, Calif., Nemanpour S; University of California Davis School of Medicine, Sacramento, Calif., Leon B; University of California Davis School of Medicine, Sacramento, Calif., Han G; University of California Davis School of Medicine, Sacramento, Calif.
Jazyk:	angličtina
Zdroj:	Plastic and reconstructive surgery. Global open [Plast Reconstr Surg Glob Open] 2022 Apr 14; Vol. 10 (4), pp. e4160. Date of Electronic Publication: 2022 Apr 14 (Print Publication: 2022).
DOI:	10.1097/GOX.0000000000004160
Abstrakt:	Drains are used in plastic surgery to remove excess fluid while ameliorating complications. However, there is a paucity of evidence supporting guiding parameters on when to discontinue a drain. The aim of our study was to determine whether two of the most common parameters, drain volume 24 hours before removal or postoperative day, are valid indicators for drain removal. Methods: A retrospective chart review was conducted for surgical operations performed by our division between July 2014 and May 2019. Of the 1308 patients, 616 had a drain and a complete record. Demographics, medical history, operative time, antibiotic use, anatomic site, donor/recipient, and complication type were recorded. Complications were defined as events that deviated from expected postoperative course or required pharmacological/procedural intervention. T -test and Chi square were used to analyze data. Results: In total, 544 patients were in the no complication group, and 72 were in the complication group. The complication group patients had drains removed later than patients in the no complication group (15.7 days versus 12.5 days, P = 0.0003) and had similar final 24-hour drain volumes versus patients in the no complication group (16.7 mL versus 18.8 mL, P = 0.2548). The complication group had more operations on the pelvis (11% versus 2.1%; P = 0.000017) or thigh (8.5% versus 3.4%; P = 0.029). Conclusions: Our data suggest neither postoperative day nor 24-hour volume before drain removal are valid indicators for removal. Late removal correlates with more complications; however, persisting output leading to later removal may be predictive of an impending complication rather than delays in drain removal causing the complication. (Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)
Databáze:	MEDLINE
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