The online version of this article (doi:10.1186/1477-7819-10-72) contains supplementary material, which is available to authorized users.
The authors have no conflict of interest with regard to the materials, methods or data reported in this paper.
All authors contributed to hypothesis and research design, data collection and manuscript editing.
Thyroid drains following thyroid surgery are routinely used despite minimal supportive evidence. Our aim in this study is to determine the impact of routine open drainage of the thyroid bed postoperatively on ultrasound-determined fluid accumulation at 24 hours.
We conducted a prospective randomised clinical trial on patients undergoing thyroid surgery. Patients were randomly assigned to a drain group (n = 49) or a no-drain group (n = 44) immediately prior to wound closure. Patients underwent a neck ultrasound on day 1 and day 2 postoperatively. After surgery, we evaluated visual analogue scale pain scores, postoperative analgesic requirements, self-reported scar satisfaction at 6 weeks and complications.
There was significantly less mean fluid accumulated in the drain group on both day 1, 16.4 versus 25.1 ml (P-value = 0.005), and day 2, 18.4 versus 25.7 ml (P-value = 0.026), following surgery. We found no significant differences between the groups with regard to length of stay, scar satisfaction, visual analogue scale pain score and analgesic requirements. There were four versus one wound infections in the drain versus no-drain groups. This finding was not statistically significant (P = 0.154). No life-threatening bleeds occurred in either group.
Fluid accumulation after thyroid surgery was significantly lessened by drainage. However, this study did not show any clinical benefit associated with this finding in the nonemergent setting. Drains themselves showed a trend indicating that they may augment infection rates. The results of this study suggest that the frequency of acute life-threatening bleeds remains extremely low following abandoning drains. We advocate abandoning routine use of thyroid drains.
Authors’ original file for figure 112957_2011_994_MOESM1_ESM.pdf
Samraj K, Gurusamy KS: Wound drains following thyroid surgery. Cochrane Database Syst Rev. 2007, 4: CD006099- PubMed
Kennedy SA, Irvine RA, Westerberg BD, Zhang H: Meta-analysis: prophylactic drainage and bleeding complications in thyroid surgery. J Otolaryngol Head Neck Surg. 2008, 37: 768-773. PubMed
Khanna J, Mohil RS, Khanna J, Mohil RS, Chintamani L, Bhatnagar D, Mittal MK, Sahoo M, Mehrotra M: Is the routine drainage after surgery for thyroid necessary? A prospective randomized clinical study [ISRCTN63623153]. BMC Surg. 2005, 5: -.
Ernst R, Wiemer C, Rembs E, Friemann J, Theile A, Schäfer K, Zumtobel V: Local effects and changes in wound drainage in the free peritoneal cavity] [in German. Langenbecks Arch Chir. 1997, 382: 380-392. PubMed
- The impact of routine open nonsuction drainage on fluid accumulation after thyroid surgery: a prospective randomised clinical trial
Peter M Neary
Owen J O’Connor
Edel M Quinn
Justin J Kelly
Ronan A Cahill
Henry P Redmond
- BioMed Central
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