Cochrane closed suction drains

Closed suction surgical wound drainage after orthopaedic surgery.

Parker MJ, Livingstone V, Clifton R, et al. The Cochrane database of systematic reviews 2007 · PMID 17636687 · doi:10.1002/14651858.cd001825.pub2

Systematic review / meta-analysisManagementOperative technique & equipmentCitation checked

Question: Does closed suction drainage after orthopaedic surgery improve wound outcomes compared with no drain?
Design: Cochrane systematic review and meta-analysis of randomised trials.
Patients: Patients having elective and trauma orthopaedic surgery, including hip and knee arthroplasty and hip fracture fixation.
Intervention: Closed suction wound drain
Comparison: No drain
Primary outcome: Wound infection, haematoma, reoperation and transfusion
Key result: Drains gave no significant benefit for infection, haematoma or reoperation, but were associated with a significantly higher blood transfusion requirement; undrained wounds needed more dressing reinforcement.
Limitations: Included trials were heterogeneous and many were small with variable quality.
Impact on practice: It supports abandoning routine drains after most orthopaedic procedures, which is now usual UK practice.