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Value of closed suction drainage in arthroscopic and minimally invasive surgery of the ankle joint: a prospective randomised study

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Closed suction drainage is an established procedure in arthroscopic surgery. It is intended to reduce the retention of wound and irrigation fluids, which form the basis for postoperative swelling, pain, and infection. However, currently, there is no scientific review of the actual benefit of this procedure.

Methods

Between 2020 and 2021, 84 patients (53 males, 31 females; mean age: 42 years) were prospectively randomised into this study. The patients underwent arthroscopic surgery of the ankle joint with (group A) or without (group B) insertion of a closed suction drain (42 patients per group). Assessments included upper ankle swelling using the figure-of-eight-20 method, pain preoperatively and 48 h postoperatively, and unexpected events within 6 weeks postoperatively.

Results

The measurements performed 48 h postoperatively showed a mean circumferential increase of 1.38 cm (1.48 and 1.28 cm in groups A and B, respectively; p > 0.05) in all patients. The mean pain at rest, assessed using the visual analogue scale (maximum 10 points), was 2.7 and 2.4 in groups A and B, respectively (p > 0.05). Overall, two minor complications occurred: residual swelling in group A and persistent limitation of movement in group B. The average length of hospital stay was 2.4 days (p > 0.05).

Conclusions

Based on the available data, the routine insertion of a closed suction drainage at the upper ankle does not offer any objective benefit and must be considered obsolete. From both a medical and an economic point of view, the decision to conduct this procedure should be justified on an individual basis.

Level of evidence

Level I, prospective randomised trial.

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Availability of data and material

All data intended for publication are included in the manuscript.

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Funding

No funding was received.

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Authors and Affiliations

  1. Department of Foot and Ankle Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Friedberger Landstr. 430, 60389, Frankfurt, Germany

    Sebastian Fischer, Charlotte Heusgen, Oliver Neun & Sebastian Manegold

  2. Orthopaedic University Hospital Friedrichsheim, Frankfurt, Germany

    Moamer Brkic

  3. Department for Trauma and Orthopaedic Surgery Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Frankfurt, Germany

    Alexander Klug & Reinhard Hoffmann

Authors
  1. Sebastian Fischer
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  2. Charlotte Heusgen
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  3. Moamer Brkic
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  4. Oliver Neun
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  5. Alexander Klug
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  6. Reinhard Hoffmann
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  7. Sebastian Manegold
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Corresponding author

Correspondence to Sebastian Fischer.

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Conflict of interest

All authors declare that they have no conflict of interest. All authors agree to the publication of the data.

Ethical statement

All procedures were performed in accordance with the 1964 Helsinki Declaration and its later amendments or comparable ethics standards.

Ethical approval

The ethics committee of the institutional review board approved this study (2020-1973-evBO).

Informed consent

All patients were informed in detail about study participation and publication of data. Written informed consent was required prior to participation in this study.

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Fischer, S., Heusgen, C., Brkic, M. et al. Value of closed suction drainage in arthroscopic and minimally invasive surgery of the ankle joint: a prospective randomised study. Arch Orthop Trauma Surg 143, 657–663 (2023). https://doi.org/10.1007/s00402-021-04107-4

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  • DOI: https://doi.org/10.1007/s00402-021-04107-4

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