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Impact of closed suction drainage after surgical fixation of acetabular fractures

  • Adam R. BoissonneaultEmail author
  • Mara Schenker
  • Christopher Staley
  • Madeline Roorbach
  • Amalie A. Erwood
  • Zachary J. Grabel
  • Thomas MooreJr.
  • William Reisman
  • Michael Maceroli
Orthopaedic Surgery
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Abstract

Introduction

The purpose of the present study was to evaluate the prevalence of closed suction drainage after a Kocher–Langenbeck (K–L) approach for surgical fixation of acetabular fractures and to determine the impact of closed suction drainage on patient outcomes.

Methods

This retrospective study reports on 171 consecutive patients that presented to a single level I trauma center for surgical fixation of an acetabular fracture. Medical records were reviewed to evaluate the use of closed suction drains. The primary outcomes measures were rate of packed red blood cell (PRBC) transfusion and length of hospital stay (LOS). Secondary outcome measures were 30-day post-operative wound complication and 1-year deep infection rates.

Results

Of the 171 patients included in this study, 140 (82%) patients were treated with drains. There was a significant association between the use of closed suction drainage and post-operative blood transfusion rate (p = 0.002). Thirty-five patients (25%) treated with drains required a post-operative blood transfusion compared to 0% in the no drain cohort. Regarding the total number of drains used, for every additional closed suction drain that was placed beyond a single drain, the odds of receiving a blood transfusion doubled (p = 0.002). Use of closed suction drainage was associated with a significantly longer LOS (p = 0.015), and no difference in wound complication or deep infection rates.

Conclusion

The use of closed suction drains for treatment of acetabular fractures using a K–L approach is associated with increased rates of blood transfusion and increased length of hospital stay, with no impact on surgical site infection rates. The results of this study suggest against routine drain usage in acetabular surgery.

Keywords

Kocher–Langenbeck Acetabular fracture Closed suction drainage Blood transfusion 

Notes

Funding

There is no funding source.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Informed consent

For this type of study formal consent is not required.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Adam R. Boissonneault
    • 1
    Email author
  • Mara Schenker
    • 1
  • Christopher Staley
    • 1
  • Madeline Roorbach
    • 2
  • Amalie A. Erwood
    • 2
  • Zachary J. Grabel
    • 1
  • Thomas MooreJr.
    • 1
  • William Reisman
    • 1
  • Michael Maceroli
    • 1
  1. 1.Department of Orthopaedic SurgeryEmory University School of MedicineAtlantaUSA
  2. 2.Emory University School of MedicineAtlantaUSA

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