Features of drainage in thyroid surgery

Abstract

Purpose – to study the efficiency of active drainage of wounds in various types of thyroid pathology and surgery volumes; study the relationship between thyroid size, scope and amount of exudation from the wound.Materials and methods. The healing of the wound and the volume of the exudation from the wound in 946 patients (including 383 patients which used anticoagulants) had been analyzed. Active drainage had been performed in 486 patients, passive drainage – in 460. Volume of active wound drainage fluid was measured in milliliters (ml) by transfusion content of drainage in a graded flask, and the passive drainage – by weighing dressing and dry mass of similar material and the addition of 20% by weight based on the dry. Thyroid volume was measured during USD by Brunn. The duration of wound healing was measured in days.Results and discussion. The mean term of healing in patients with active drainage was statistically significantly shorter, than in patients with passive drainage. The dependence of volume of exudation and the size of removed gland has been revealed. The more the volume of the gland, the more was the exudation. At equal volumes of thyroid exudation amount was larger in patients operated for Graves' disease and thyroid cancer. This dependence may be associated with altered vascular permeability and increased metabolism in Graves' disease, as well as injuries due to central neck dissection for cancer of the thyroid. The use of anticoagulants increases the amount of fluid from postoperative wounds by 12-30% (average 18%).Conclusions. The use of active drainage during operations on the thyroid gland is more effective than passive drainage, leading to rapid recovery and rehabilitation. The closure of surgical wounds without drain is effective and safe in cases of hemithyroidectomy or thyroidectomy for multinodular goiter when the volume of removed tissue does not exceed 15 cm³ in patients not using anticoagulants.