USE OF DRAINS IN SPINE SURGERY SYSTEMATIC REVIEW & META ANALYSIS

Abstract

Wound suction drains have been used to decrease the rate of postoperative hematoma formation and thus wound infections for many years throughout all surgical subspecialties. Although the use of surgical drains dates back to the years of Hippocrates, in the orthopedic literature these drains have not been shown to be beneficial in decreasing the rates of these complications, especially in orthopedic procedures including fracture fixation or arthroplasty surgeries. However, these drains are still commonly used throughout the orthopedic community, including spine surgery. Debate in this area remains, as proponents of its use in the immediate postoperative period believe that it will prevent fluid collection in the surgical dead space, and thus eliminates the media for bacterial growth. On the other hand, opponents believe that they are considered a foreign body that promotes inflammation and even sometimes provokes an infectious response. In spine surgery, the controversy is even more profound because it decreases the rare but devastating complication of postoperative epidural hematoma, but it may have a hypothetical increase in the risk of infection(1).