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Comparison between subcutaneous closed-suction drainage and conventional closed-suction drainage in adolescent idiopathic scoliosis patients undergoing posterior instrumented spinal fusion: a randomized control trial

STUDY DESIGN: Prospective, randomized controlled clinical study. OBJECTIVE: To evaluate the efficacy of subcutaneous closed-suction drainage in reducing blood loss as compared with conventional closed-suction drainage in adolescent idiopathic scoliosis cases undergoing posterior instrumented spinal fusion. BACKGROUND: Subcutaneous closed-suction drainage is reported to be a reasonable alternative to intra-articular indwelling closed-suction drainage and to that of no usage of any drainage system in knee arthroplasty. However, little is reported about the use of subcutaneous closed-suction drainage in adolescents idiopathic scoliosis patients undergoing posterior instrumented spinal fusion. METHODS: A total of 105 adolescent idiopathic scoliosis patients undergoing posterior instrumented spinal fusion were randomized into 2 groups of either a subcutaneous drainage or a conventional closed-wound suction drainage system. These 2 groups were compared for demographic distribution, blood loss (hemoglobin/hematocrit changes, transfusion requirements), and incidence of wound problems (requirements for dressing reinforcement, oozing, subcutaneous hematoma, ecchymosis, infection). RESULTS: Mean drainage volume was less (P=0.000) in the subcutaneous closed-wound suction drainage group compared with the conventional closed-wound suction drainage group (42 vs. 631 mL). The groups were statistically similar in terms of hemoglobin and hematocrit values obtained on the third postoperative day (10.60 vs. 9.52 g/dL, P=0.110; 30.85% vs. 27.82%, P=0.226), on discharge (10.90 vs. 9.75 g/dL, P=0.114; 31.10% vs. 28.13%, P=0.147), transfusion requirements (31.2% vs. 45.6%, P=0.133), and incidence of wound problems. However, the core temperature values were higher in subcutaneous closed-wound suction drainage group compared with the conventional closed-wound suction drainage group (P=0.001), and the duration of fever was longer in the former compared with the latter (P=0.008). CONCLUSIONS: The data suggest that subcutaneous closed-suction drainage offers a reasonable alternative to closed-wound suction drainage in adolescents idiopathic scoliosis patients undergoing posterior instrumented spinal fusion

Keywords : Adolescent,Arthroplasty,blood,Child,China,Drainage,Female,Fever,Hematoma,Humans,Incidence,Infection,instrumentation,Knee,Male,methods,pathology,Patients,Prospective Studies,Scoliosis,Spinal Fusion,Subcutaneous Tissue,Suction,surgery,Temperature,, Between,Subcutaneous,Closedsuction,Drainage, vulvodynia treatment

Date of Publication : 2013 Jul

Authors : Liang J;Qiu G;Chua S;Shen J;

Organisation : Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Beijing, China

Journal of Publication : J Spinal Disord Tech

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/22134736

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