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No relationship found between drain usage, complications after TSA
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Closed drain usage during total shoulder arthroplasty had no significant relationship with postoperative complications, according to results published in Orthopedics.
After identifying 636 patients undergoing either primary total shoulder or reverse total shoulder arthroplasty (TSA) from February 2013 to February 2015, researchers reviewed patient medical records for potential risk factors in the patients’ past medical history and postoperative complications and recorded whether a closed drainage system was used.
Investigators included 378 of the original 636 patients undergoing shoulder arthroplasty, of which 29.4% cases included the use of drains. Eleven patients experienced a complication, including deep infection, superficial infection and hematoma formation, with a drain used in one case. Researchers noted no statistically significant relationship between drain use and postoperative complications. According to results, no significant relationship was identified when researchers stratified complications by the presence or absence of risk factors, irrespective of whether a drain was used. – by Casey Tingle
Disclosures: The authors have no relevant financial disclosures.
Perspective
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Andrew Jawa, MD
I commend the authors on their study to answer the question of whether drains are helpful in TSA. In short, I believe the study is inconclusive because of the methodology. Inherently, there was something different at the time of surgery for the patients who received the drains (more bleeding, surgeon preference, diagnosis, etc.) and the groups cannot be fairly compared. That said, I agree with the sentiment of the authors that drains are not likely needed routinely, but each surgeon must use clinical judgment for each individual case.
New England Baptist Hospital
Assistant professor, Tufts Medical School
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