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The following is a summary of “Advancing the timing of drainage removal: a comprehensive analysis of different drainage removal criteria in patients undergoing short-level lumbar fusion surgery,” published in the December 2024 issue of Surgery by Cui et al.  

Individuals undergoing short-level lumbar fusion surgery often require drainage to manage postoperative fluid accumulation. The timing of drainage removal can influence recovery outcomes.  

Researchers conducted a retrospective study to evaluate the safety and benefits of different drainage removal criteria in individuals undergoing short-level lumbar fusion surgery.  

They included individuals with degenerative lumbar diseases who underwent short-level lumbar fusion with instrumentation (January 2021 and January 2023). Based on drainage removal criteria (50 ml vs. 100 ml/24 hours), individuals were divided into 2 groups (A and B). To control for confounding factors, a 1:1 nearest propensity score matching was performed between the groups, considering significant variations such as age, gender, body mass index (BMI), number of fused levels, intraoperative blood loss, and surgical duration. Perioperative outcomes were compared, and multivariate logistic regression was used to identify complication risk factors.  

The results showed that individuals in group B had significantly more drainage removed on postoperative day (POD) 2 (23.1% vs. 32.1%, P=0.012) and POD 3 (37.0% vs. 45.1%, P=0.041). Individuals in group B ambulated earlier (3.87 ± 1.12 vs. 2.41 ± 1.34, P=0.012). No significant difference in symptomatic hematoma or surgical site infection was observed, and overall complications were fewer in group B (10.39% vs. 5.19%, P=0.016). Multivariate logistic regression identified early ambulation as an independent risk factor for overall complications (OR 2.38, 95% CI 1.19–3.97, P<0.001).  

They concluded that the relaxation of drainage removal criteria significantly shortens the length of stay (LOS), promotes early postoperative ambulation, and reduces overall perioperative complications.  

 Source: bmcsurg.biomedcentral.com/articles/10.1186/s12893-024-02726-3