EFFICACY OF SURGICAL-WOUND DRAINAGE IN ORTHOPEDIC TRAUMA PATIENTS - ARANDOMIZED PROSPECTIVE TRIAL

Objective: To study the efficacy of closed suction drainage in clean n onemergent surgical fracture fixation or bone grafting on the extremit ies or pelvis. Design: A prospective randomized trial. Setting: The or thopaedic trauma service of a Level I trauma hospital. Patients: Patie nts were older than age eighteen years and undergoing clean nonemergen t surgical fracture fixation or bone grafting procedures on the extrem ities (excluding hands and feet) or pelvis. Intervention: The applicat ion of a surgical drain. Main Outcome Measurements: Wound drainage, ed ema, hematoma and erythema, dehiscence, infection, and need for surger y or readmission were followed for six weeks. A univariate analysis wi th Student's t test for continuous variables and chi-squared analysis for all categorical data were used, with ap value of less than or equa l to 0.05 considered statistically significant. Results: A total of 20 2 patients were randomized to 102 patients with no drain and 100 patie nts with a drain. There was no significant difference between the grou ps with regard to injury severity, systemic disease, age, body weight, physical status, or estimated blood loss. There was no significant di fference between the drain and no-drain groups in any of the parameter s evaluated. Conclusion: There is no significant difference between dr ained and nondrained wounds in clean, nonurgent orthopaedic trauma sur gery. It appears that drainage systems can be safely eliminated in thi s group.