Impact of closed suction drainage after surgical fixation of acetabular fractures

Boissonneault, Adam; Schenker, Mara L.; Staley, Christopher; Roorbach, Madeline; Erwood, Amalie A.; Grabel, Zachary J.; Moore, Thomas J.; Reisman, W. Michael; Maceroli, Michael

doi:10.1007/s00402-019-03110-0

Cited by 5 publications

(4 citation statements)

References 30 publications

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“…A retrospective study by Reddix et al (23) showed that the use of CSD in patients with acetabular fracture may significantly reduce the incidence of deep infections. Although certain high-risk patients with acetabular fractures, such as obese patients, may benefit from treatment with CSD, the use of CSD remains (24) show that, in their study, the use of CSD after the surgical fixation of acetabular fractures via the Kocher-Langenbeck approach significantly increased postoperative blood transfusion rates and days in hospital, but wound complications and incision infection rates did not differ.…”

Section: Discussionmentioning

confidence: 97%

Drain vs. no-drain for acetabular fractures after treatment via a modified stoppa approach: A retrospective study

Jin

Wang²,

Zhao³

et al. 2023

Front. Surg.

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ObjectiveThe aim of this study was to compare the clinical efficacy of close suction drainage (CSD) and no-CSD after a modified Stoppa approach for the surgical fixation of acetabular fractures.MethodsThis retrospective study included 49 consecutive acetabular fracture patients, who presented to a single level I trauma center for surgical fixation, using a modified Stoppa approach from January 2018 to January 2021. All surgeries were performed by a senior surgeon using the same approach, and the patients were divided into two groups based on whether CSD was used after the operation. Details of the patient demographics, fracture characteristics, intraoperative indicators, reduction quality, intra and postoperative blood transfusion, clinical outcomes, and incision-related complications were collected.ResultsNo significant differences were found in the demographics, fracture characteristics, intraoperative indicators, reduction quality, clinical outcomes, and incision-related complications between the two groups (P > 0.05). The use of CSD was associated with a significantly higher postoperative blood transfusion volume (P = 0.034) and postoperative blood transfusion rate (P = 0.027). In addition, there was a significant difference in postoperative temperatures, especially on postoperative Day 2 (no-CSD 36.97 ± 0.51°C vs. CSD 37.34 ± 0.69°C, P = 0.035), and higher visual analogue scale (VAS) scores, especially on postoperative Day 1 (no-CSD 3.00 ± 0.93 vs. CSD 4.14 ± 1.43, P = 0.002) and 3 (no-CSD 1.73 ± 0.94 vs. CSD 2.48 ± 1.08, P = 0.013).ConclusionThe results of this study suggest that routine use of CSD should not be recommended for patients with acetabular fractures after surgical fixation using a modified Stoppa approach.

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Section: Discussionmentioning

confidence: 97%

Drain vs. no-drain for acetabular fractures after treatment via a modified stoppa approach: A retrospective study

Jin

Wang²,

Zhao³

et al. 2023

Front. Surg.

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“…The use of closed suction drains is surgeon-dependent but has been associated with increased transfusions and length of stay with no difference in the infection rate. 43 Standard postoperative pain control and thromboprophylaxis protocols are followed. Weight-bearing restrictions are typically touch down for 6 to 8 weeks but may be modified for cases with marginal impaction or cranial joint involvement.…”

Section: Surgical Managementmentioning

confidence: 99%

“…The use of closed suction drains is surgeon-dependent but has been associated with increased transfusions and length of stay with no difference in the infection rate. 43…”

Section: Treatmentmentioning

confidence: 99%

“…Utilization of prophylactic antibiotics helps to mitigate infection while placement of suction drains to prevent hematoma formation and close dead space does not necessarily decrease infection nor wound healing complications. 43 Acute sciatic nerve palsy secondary to hematoma formation has been described and requires prompt recognition and surgical evacuation. 44 Risk of DVT is also decreased by utilization of intermittent compressive devices and chemical anticoagulation.…”

Section: Complicationsmentioning

confidence: 99%

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Evaluation and Management of Posterior Wall Acetabulum Fractures

Perdue

Tainter

Toney

et al. 2021

J Am Acad Orthop Surg

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Posterior wall acetabulum fractures typically result from high-energy mechanisms and can be associated with various orthopaedic and nonorthopaedic injuries. They range from isolated simple patterns to multifragmentary with or without marginal impaction. Determination of hip stability, which can depend on fragment location, size, and displacement, directs management. Although important in the assessment of posterior wall fractures, CT is unreliable when used to determine stability. The dynamic fluoroscopic examination under anesthesia (EUA) is the benchmark in assessment of hip stability, and fractures deemed stable by EUA have good radiographic and functional outcomes. In fractures that meet surgical criteria, accurate joint reduction guides outcomes. Joint débridement, identification and elevation of impaction, and adjunctive fixation of posterosuperior and peripheral rim fragments along with standard buttress plate fixation are critical. Complications of the fracture and surgical fixation include sciatic nerve injury, posttraumatic osteoarthritis, osteonecrosis of the femoral head, and heterotopic ossification. Although accuracy of joint reduction is paramount for successful results, other factors out of the surgeon's control such as comminution, femoral head lesions, and dislocation contribute to poor outcomes. Even with anatomic restoration of the joint surface, good clinical outcomes are not guaranteed and residual functional deficits can be expected.

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Drainage relieves pain without increasing post-operative blood loss in high tibial osteotomy: a prospective randomized controlled study

Yang²,

Watson

et al. 2020

International Orthopaedics (SICOT)

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Impact of closed suction drainage after surgical fixation of acetabular fractures

Cited by 5 publications

References 30 publications

Drain vs. no-drain for acetabular fractures after treatment via a modified stoppa approach: A retrospective study

Drain vs. no-drain for acetabular fractures after treatment via a modified stoppa approach: A retrospective study

Evaluation and Management of Posterior Wall Acetabulum Fractures

Drainage relieves pain without increasing post-operative blood loss in high tibial osteotomy: a prospective randomized controlled study

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