Abstract
| Language | English |
|---|---|
| Pages | 55-61 |
| Number of pages | 7 |
| Journal | Journal of Clinical Neuroscience |
| Volume | 53 |
| Early online date | 19 Apr 2018 |
| DOIs | |
| Publication status | Published - Jul 2018 |
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Keywords
- Epidural hematoma
- Laminectomy
- Microdiscectomy
- Systematic review
- Wound drain
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A systematic review and meta-analysis of wound drains in non-instrumented lumbar decompression surgery. / Davidoff, Christopher L.; Rogers, Jeffrey; Simons, Mary; Davidson, Andrew.
In: Journal of Clinical Neuroscience, Vol. 53, 07.2018, p. 55-61.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - A systematic review and meta-analysis of wound drains in non-instrumented lumbar decompression surgery
AU - Davidoff, Christopher L.
AU - Rogers, Jeffrey
AU - Simons, Mary
AU - Davidson, Andrew
PY - 2018/7
Y1 - 2018/7
N2 - Wound drains are routinely used in lumbar decompressive surgery (LDS). However, it remains unclear whether this practice helps to prevent symptomatic epidural hematoma formation and associated complications, particularly following non-instrumented procedures. A systematic review and meta-analysis was therefore completed to critically appraise the literature. The search protocol was conducted using the Ovid MEDLINE, EMBASE, Scopus, Cochrane Library, and Google Scholar databases. Articles meeting the following criteria were included: (i) examined patients undergoing LDS; (ii) included cases receiving post-operative wound drains; (iii) detailed adverse outcomes including symptomatic epidural hematomas or wound infection; and (iv) were published in English in a peer-reviewed journal. Pooled risk differences (RD) for adverse outcomes were calculated using Comprehensive Meta-Analysis software. Three Level 1b prospective randomized studies and five Level 2b retrospective cohort studies were included, from which 5,327 cases were identified as having received a surgical drain and 773 were identified as having received no drainage following non-instrumented LDS. There was no difference between groups in the risk of symptomatic epidural hematoma (RD = 0.02; 95% CI -0.02 - 0.06, p = 0.28) or post-operative infection (RD = 0.00; 95% CI -0.01 - 0.01, p = 0.91). In conclusion, symptomatic epidural hematomas and infection are rare following non-instrumented LDS, with incidence rates unaffected by the routine use of wound drainage.
AB - Wound drains are routinely used in lumbar decompressive surgery (LDS). However, it remains unclear whether this practice helps to prevent symptomatic epidural hematoma formation and associated complications, particularly following non-instrumented procedures. A systematic review and meta-analysis was therefore completed to critically appraise the literature. The search protocol was conducted using the Ovid MEDLINE, EMBASE, Scopus, Cochrane Library, and Google Scholar databases. Articles meeting the following criteria were included: (i) examined patients undergoing LDS; (ii) included cases receiving post-operative wound drains; (iii) detailed adverse outcomes including symptomatic epidural hematomas or wound infection; and (iv) were published in English in a peer-reviewed journal. Pooled risk differences (RD) for adverse outcomes were calculated using Comprehensive Meta-Analysis software. Three Level 1b prospective randomized studies and five Level 2b retrospective cohort studies were included, from which 5,327 cases were identified as having received a surgical drain and 773 were identified as having received no drainage following non-instrumented LDS. There was no difference between groups in the risk of symptomatic epidural hematoma (RD = 0.02; 95% CI -0.02 - 0.06, p = 0.28) or post-operative infection (RD = 0.00; 95% CI -0.01 - 0.01, p = 0.91). In conclusion, symptomatic epidural hematomas and infection are rare following non-instrumented LDS, with incidence rates unaffected by the routine use of wound drainage.
KW - Epidural hematoma
KW - Laminectomy
KW - Microdiscectomy
KW - Systematic review
KW - Wound drain
UR - http://www.scopus.com/inward/record.url?scp=85045575225&partnerID=8YFLogxK
U2 - 10.1016/j.jocn.2018.04.038
DO - 10.1016/j.jocn.2018.04.038
M3 - Article
VL - 53
SP - 55
EP - 61
JO - Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
T2 - Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
JF - Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
SN - 0967-5868
ER -