Use of wound drains following open reduction and internal fixation of femoral shaft fractures

Abstract

To determine if routine use of closed suction wound drainage is justified following open reduction and internal fixation of femoral-shaft fractures. Patients undergoing reduction and internal fixation of 75 femoral shaft fractures were prospectively randomised into two groups: one receiving closed-suction drainage (CSD) and one no wound drainage (NWD). The state of the wound dressing at 24 and 48 hours post-surgery, blood transfusion requirements, status of the wound (presence of hyperaemia, surgical site infection, undue wound tenderness, presence of induration at the wound edge and wound healing) at days 7, 14, 28 and 90 postoperatively, and duration of wound healing, were assessed. A total of 65 patients, with 75 femoral shaft fractures, completed the study: 37 fractures in CSD group and 38 in the NWD group. No significant difference was observed between the two groups in terms of the state of wound dressing at 24 hours (p=0.192) or 48 hours (p=0.365). There was no statistically significant difference in the incidence of wound infection (X2=3.339, df=2, p=0.188) or duration of wound healing (X2=3.168, df=1, p=0.075) between the two groups. However, more patients in the CSD group had blood transfusions than in the NWD group (21.6% vs 15.8%), although this was also not statistically significant (p=0.181). No benefit was observed in the routine use of wound drains following open reduction and internal There were no external sources of funding for this study. The authors have no additional conflicts of interest to declare.