Closed suction surgical wound drainage after orthopaedic surgery

Wound drains do not appear to have any effect on the incidence of wound infections or haematomas in orthopaedic surgery, but bruising of the wound and the need for reinforcement of dressings is less for drained wounds.

A Cochrane review included 36 studies with a total of 5 464 subjects. The types of surgery involved were hip and knee replacement, shoulder surgery, hip fracture surgery, spinal surgery, cruciate ligament reconstruction, open meniscectomy and fracture fixation surgery. Pooling of results indicated no statistically significant difference in the incidence of wound infection (Total Hip Replacement (THR) RR 0.89, 95%CI 0.56 to 1.43) or For Total Hip Replacement (TKR) RR 0.80, 95%CI 0.24 to 2.60), haematoma (RR 1.20, 95%CI 0.39 to 3.66), dehiscence or re-operations between those allocated to drains and the un-drained wounds. Surgical procedures such as fracture surgery and spinal surgery have not been adequately studied. Blood transfusion was required more frequently in those who received drains. The need for reinforcement of wound dressings and the occurrence of bruising were more common in the group without drains.

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1. Parker MJ, Livingstone V, Clifton R, McKee A. Closed suction surgical wound drainage after orthopaedic surgery. Cochrane Database Syst Rev 2007 Jul 18;(3):CD001825.