Kevin Bargoin*1, Jean-Marc Glasson2, Jacques-Emmanuel AYEL3, Emmanuel BEAUDOUIN,4 Régis GUINAND5 and Anne Vidil6
1Private Confluent Hospital, Nantes, France
2Imperial Park Clinic, Nice, France
3Cedars Clinic, CORNEBARRIEU, France
4Hospital Center Savoie Metropolis, Chambéry, France
5New Clinic of the Union, Saint-Jean, France
6Clinique Bizet, Paris, France
*Corresponding Author: Kevin Bargoin, Private Confluent Hospital, Nantes, France.
Received: May 13, 2022; Published: September 09, 2022
Objectives of the study: It is common to drain the operative wound to limit the occurrence of postoperative hematoma after shoulder prosthesis (TSA). The interest of drainage has been questioned in hip and knee replacement surgeries for the sake of blood saving. Rapid recovery protocols after surgeries are suitable for shoulder surgery and the usefulness of drainage is a determining factor. A prospective, multicenter controlled study was performed on shoulder prostheses with or without drainage to analyze blood loss, mean length of stay (SMD) and complications.
Hypothesis: the drain increases the length of hospitalization and does not decrease the risk of complications.
Material and Method: A continuous prospective study was carried out on 6 centres in France for a total of 139 TSA over a year divided into 2 groups, the first 6 months with drainage (AD: 80 TSA) and the following 6 months without drainage (SD: 59 TSA). The study compared the 2 groups with clinical scores in preoperative and at 6 months postoperatively (M6): Constant, SST, SSV and ASES. Blood loss was assessed on the evolution of hemoglobin (Hb) levels, the volume of the redon on the 1st and2nd day and any transfusions. SMD and postoperative complications were identified. The groups with and without drain are comparable in age, ASA score and types of prosthesis.
Results: No significant difference on the constant (M6) AD scores: 62 points (pts), SD: 60 pts p = 0.37, ASES, SST, SSV nor on the rate of change in preoperative hemoglobin and J2 AD (-1.87g/dL) SD (-1.83g/dL). No significant difference on the SMD (3.9d – 4.1d) with extremes of 2 to 15 days. A difference in SMD is found depending on the etiology: fractures vs other causes (6.06days - 3.7 days) p = 0.015. Analysis of complications was less hematoma collected in the drain group AD 2.5%, SD 8.5%, not significant p = 0.13, 4 times in the group with drain vs 2 times in the group without drain.
Discussion: Drainage did not increase blood loss, lack of drainage did not decrease SMD in our study. The main factor in increasing SMD is traumatic etiology with a SMD that is often greater than a week. Drainage does not influence the recovery rate. Systematic drainage is above all a matter of practice.
Conclusion: Drainage does not appear to be essential for shoulder prostheses in patients who do not have a coagulation abnormality.
Level of Evidence: III
Keywords: Drainage; Shoulder Arthroplasty; Multicenter
Citation: Kevin Bargoin., et al. “Interest of Drainage in Shoulder Arthroplasty: A Prospective Multicenter Study".Acta Scientific Orthopaedics 5.10 (2022): 84-90.
Copyright: © 2022 Kevin Bargoin., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.