Do Superficial Drains Make a Difference After Lumbar Fusion Surgery? A Prospective, Randomized Trial.

Abstract

Study design: A prospective, randomized study.

Objective: The goal of this study was to evaluate the impact that subcutaneous drains have on patient satisfaction and postoperative recovery after a lumbar fusion surgery.

Summary of background data: The use of drains following lumbar fusion surgery is controversial. Current literature shows that there are both benefits and drawbacks to using deep drains, however, there are no reports on the utility of superficial drains.

Methods: One hundred ten patients undergoing a 1 to 3-level fusion by a single surgeon were randomly selected to receive either a subcutaneous drain (55 patients) or no drain (55 patients). Drain output was collected 1, 3, and 5 days after the procedure. Drains were removed 5 days after the surgery so long as the output was <50 ccs in a 24-hour period. Patient demographics, drain outputs, and questionnaire data from 10, 30, and 60 days after the procedure were compared.

Results: Patients receiving a superficial drain were significantly less likely to have incisional drainage (P<0.01) and tended to be less anxious about their wound healing (P=0.06). There was no difference between drain and no drain groups in terms of postoperative complications, wound care satisfaction, level of independence, or need for outside medical assistance. Body mass index (BMI) and wound thickness did not impact the volume of drain output or other results.

Conclusions: Subcutaneous drains significantly decrease incisional leakage and tend to decrease patient anxiety regarding wound healing. The presence of a postoperative drain does not diminish patient satisfaction with wound healing.