16.0: Thursday, March 17, 2005

Are Drains Necessary after Craniosynostosis Surgery?

Aaron Gorin, MD, Sreyram Kuy, Richard Shih, Shelley Winn, and Wayne Ozaki.

Purpose: Surgical correction of craniosynostosis involves a coronal incision, subperiosteal dissection, cranial bone reconstruction and autogenous bone grafting. Upon completion, many surgeons choose to place subperiosteal drains. To date, there are no studies comparing use of drains to no drains for these procedures.

Methods: A retrospective study examined 24 craniosynostosis cases performed between 2001 and 2004. 9 patients had postoperative drains and 15 patients did not. The study looked at age, estimated blood loss, blood transfused, preoperative, postoperative and discharge hematocrit, length of ICU stay, and length of overall hospital stay.

Results: There were no infections, wound dehiscence, or flap loss in any of the patients. No statistically significant differences were observed for age, blood loss, the amount of blood transfused, length of ICU stay, and length of overall hospital stay when comparing patients using drains and those not using drains. The use of drains did cause a statistically significant drop in the hematocrit during the postoperative period (p=.0036).

Conclusion: Avoiding drains does not increase the risk of infection, wound dehiscence, flap loss or increase hospital stay. These data obtained in this small retrospective study suggest that drains are not necessary and may even lead to greater postoperative bleeding.