Closed Wound Sub-Fascial Suction Drainage in Posterior Fusion Surgery for Adolescent Idiopathic Scoliosis A Prospective Randomize Control study

Background: PSF is the mainstay of surgical treatment for AIS. Drains are commonly used despite contradictory findings in the literature for their having any clear advantage.

Objective: To compare the complication rate in adolescent idiopathic scoliosis (AIS) posterior spinal fusion (PSF) surgery with and without drainage.

Study Design: Prospective randomized control study.

Methods: A total of 100 AIS patients undergoing instrumented PSF were blindly randomized into 2 groups of either a deep drain or no drain. The collected data included wound follow-up findings, hemoglobin, hematocrit, vital signs and fever levels, and mean 20 months follow-up.

Results: Fifty-two patients were randomly allocated to the “no drain” group and 48 to the “drain” group. There were no differences in patient characteristics, surgical data and hemoglobin and hematocrit levels between the 2 groups. Only 4 units of packed cells were given in total. Fever during the first postoperative 1-3 days was equal, but increased in the no drain group on day 6 (P = 0.017). Length of hospitalization was equal (6 days) for all the patients. The mean follow-up period was 20 months [8.5-30.7 (SD 6.4)]. Complications included one case (1.9%) of pneumonia in the “no-drain” group, wound dehiscence in 2 cases (3.8%) in the “no-drain” group and in one case (2.1%) in the “drain” group, and 2 cases (3.8%) of superficial wound infection in the “no-drain” group. There was no case of deep infection in either group.

Conclusion: The current results indicate that there is no advantage to deep drainage in AIS patients undergoing PSF. The number of wound healing complications was low and identical for both the drain and no-drain groups.

Level of Evidence: II

Key words: Sub-Fascial Suction Draine, Posterior Fusion Surgery, Adolescent Idiopathic Scoliosis.