No benefit from post-caesarean wound drainage - A prospective randomised controlled trial

Aim of the study: A prospective randomized controlled trial to determine th e benefit of caesarean wound drainage in 305 low-risk pregnant women. Methods: Pregnant women at low risk of haemorrhage undergoing caesarean sec tion in the Department of Obstetrics,University Hospital, Zurich, between J une 1998 and July 1999 were randomised after informed consent into a no-suc tion group (n = 154) without post-caesarean wound drainage versus a control group with wound drainage (subfascial and subcutaneous) (n = 151). Outcome measures were perioperative decrease in haemoglobin (Hb), postpartu m fever (>38.5 degreesC for >2 days), sonographic haematoma and other compl ications requiring revision, cumulative opiate dose adjusted to body weight , length of hospitalisation and operation time. Results: 305 patients completed the study. Decrease in Hb and the rates of fever, haematoma and revision were similar in both groups. However, cumulat ive opiate dose was lower in the no-suction group (4.5 +/- 1.8 vs 2.8 +/- 1 .4 injections, p = 0.0001), and hospital stay was shorter (6.5 +/- 2.4 vs 7 .4 +/- 2.8 days, p = 0.0058), as was operation time (32.7 +/- 11.3 v 36.1 /- 10.5 min; p = 0.0071). Conclusions: Routine post-caesarean wound drainage is not only useless but cost-ineffective. In the light of our results, wound drainage may be questi oned and should be analysed generally.