Artikel
When to pull the drainage? – a prospective analysis of the postoperative drainage volume after lumbar fusion
Wann kann die Drainage raus? – Eine prospektive Analyse des postoperativen Drainagevolumens nach lumbaler Fusion
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Autoren
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Philipp Egenolf
- Universitätsklinikum Köln, Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Köln, Deutschland
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Maximilian Lenz
- Universitätsklinikum Köln, Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Köln, Deutschland
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Klaus Schnake
- Malteser Waldkrankenhaus St. Marien, Interdisziplinäres Zentrum für Wirbelsäulen- und Skoliosetherapie, Erlangen, Deutschland; Klinikum Nürnberg, Universitätsklinik der Paracelsus Medizinischen Privatuniversität, Klinik für Orthopädie und Unfallchirurgie, Nürnberg, Deutschland
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Arne Harland
- Universitätsklinikum Köln, Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Köln, Deutschland
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Stavros Oikonomidis
- Universitätsklinikum Köln, Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Köln, Deutschland
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Peer Eysel
- Universitätsklinikum Köln, Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Köln, Deutschland
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Max J. Scheyerer
- Universitätsklinikum Köln, Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Köln, Deutschland
| Veröffentlicht: | 25. Mai 2022 |
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Gliederung
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Objective: Wound drainage is used regularly after spinal surgery to avoid postoperative epidural hematoma. However, their use and the duration of the inserted drainage are controversial. The aim of our prospective observational study was to investigate the total drainage volume (TDV) after lumbar dorsal fusions on the lumbar spine and the course of the drainage filling in order to define an ideal time to pull the drainage.
Methods: We included all patients in the observation period who underwent monosegmental surgery via TLIF (transforaminal lumbar interbody fusion) or PLIF (posterior lumbar interbody fusion). Patients with an infectious or tumorous disease or with a symptomatic postoperative epidural hematoma were excluded. A total of 27 patients (nTLIF = 20; nPLIF = 7) were included in the study. The drainage volume (DV) was measured three times a day and the volume when the drainage was pulled was documented (TDV).
Results: The total drainage volume (TDV) was significantly higher in PLIF patients than in TLIF patients (PLIF = 337.14 ml, TLIF = 215.5 ml, p = 0.047). The observation of the drainage volume showed a significant increase up to the evening of the first postoperative day (NS1) in both groups. This time point NS1 averaged 32.8 hours (± 1.7 hours) after the end of the operation. The drainage volume at NS1 was 202.5 ml (± 106.6 ml) for TLIF and 330.0 ml (± 162.9 ml) for PLIF, which corresponds to 94.7% of the individual total drainage volume (TDV) across groups (TLIF = 93.3%, PLIF = 98.2%). The mean TDV was 215 ml (± 120.2 ml) for TLIF and 337.1 ml (± 165.0 ml) for PLIF.
Conclusion: Our study shows that the drainage volume increases significantly by the evening of the first postoperative day (NS1), which was on average 32.8 hours after the operation. As conclusion, pulling the drain can be recommended from this point on in order to reduce the drainage duration to a necessary minimum.
