Modified Calculation of Average Active Drain Output Allows their Earlier Removal in Head and Neck Surgery

Česká verzia

Authors: Richard Salzman ; M. Brož; I. Stárek
Authors place of work: Otolaryngologická klinika FN Olomouc, Lékařská fakulta Univerzity Palackého v Olomouci, přednosta prof. MUDr. I. Stárek, CSc.
Published in the journal: Otorinolaryngol Foniatr, 64, 2015, No. 1, pp. 22-27.
Category: Original Article

Summary

Introduction:
Drains with active suction are routinely used in head and neck surgery in order to decrease risk of postoperative complications. Majority of surgeons remove drains when the average drain output drops under 1 mL/hour. Significantly higher output during the first postoperative hours skews their computation. Therefore, we didn’t include the first postoperative hours in this calculation. We rather started at 6pm of the day of surgery. The aim of the study was to determine if the alteration of the way the average output to drains is calculated, will allow their earlier removal.

Methods:
In the prospective randomized study, 36 patients (38 surgeries with postoperative active drainage) were included in February 2013 to May 2041. All surgeries were performed by 2 experienced head and neck surgeons

The average drain output was calculated from 6 pm of the day of surgery till 6am of the following morning in seventeen patients after 18 surgeries (group A). Subsequent estimations were done always at 6am, and again and again after 24 hours.

In nineteen patients (group B) having 20 surgeries, the average drain output was computed traditionally, i.e. from the drain insertion at the end of surgery till 6am following morning. Later calculations were performed identically to group A.

Using statistical methods, we compared the time from the end of surgery to drain removal.

Results:
In group A, drains were removed on day 1 in 55.6 % cases. The remaining drains were removedon day 2. In group B, the very first drains were extracted on day 2 (in 72.2 % of patients). Remainders of drains were removed between day 3 and 4. The comparison of results between the groups was statistically significant.

Conclusion:
Minor alteration in the calculation of average drain output allows their earlier and still safe removal.

Keywords:
active suction drain, bleeding, drain, drainage, haematoma, neck dissection, length of hospitalization, surgery

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