HIGH-VACUUM OR PASSIVE DRAINS IN THYROID- SURGERY - EFFICIENCY CONTROL BY ULTRASONOGRAPHIC MEASUREMENT OF RESTING HEMATOMA

In a prospective randomized trial, the common high-vacuum drainage sys tem according to Redon was compared with the nonsuction system accordi ng to Robinson in 80 patients undergoing elective thyroid surgery betw een January 1995 and August 1995. Forty patients were provided with no nsuction, passive drains, and another 40 patients were allocated to a control group with the high-vacuum system. Twenty-four h postoperative ly, the wound area was analyzed by sonography after drainage removal. The dimension of the remaining hematoma was determined by scanning the operation field in six to seven layers (thickness per layer T = 1 cm) . The area (A) of the hematoma was measured per layer, and thus the vo lume was determined by the formula: V = T x (A(1) + A(2..) + A(n)). Si multaneously, the quantity of discharge was determined. Patients recei ving nonsuction drainage had significantly lower median drainage volum e (34 ml; range: 0-175 mi vs 115 mi; range: 40-346 mi; P<0.01) and a r emaining hematoma, measured sonographically, of similar volume to that of the patients receiving high-vacuum treatment (4.4 mi; range: 0-21. 7 mi vs 5.3 mi; range: 0.6-24.9 mi; not significant). No complications were observed. An advantage to using the nonsuction device is seen wi th respect to similar resting wound hematoma, lower fluid evacuation, and painless drain removal. This study supports prophylactiy routine n onsuction wound drainage after elective thyroid surgery.