Drainage Or Not After Spinal Posterior Surgery:a System Evaluation

Objective:To compare in whether to give the closed drainage in the spinal posterior incision, and complications, and incision infection status line system evaluation analysis, etc. Methods:Randomized controlled trials(RCTs)and controlled clinical trials(CCTs) of closed suction drainage versus non-drainage for Spinal posterior approach via PubMed(from1996to July2013), EMBase(from1974to July2013), Cochrane library,Springer, WANFANG database (from1993to July2013), CNKI(from1994to July2013)and the relevant Chinese and English orthopedic journals. The rate of postoperative incision infection, incidence of incision haematoma, Postoperative neurological damage accidents and the amount of bleeding were chosen as evaluation indexes for the present Meta-analysis.the forest plots were conducted with RevMan5.2software,and the system review was performed using the method recommended by the Cochrane Collaboration.Results:Four studies involving392the patients were included which closed suction drainage versus non-drainage for Spinal posterior approach. The results showed a lower rate of Hemoglobin decline rate with the non-drainage compared to the drainage [weighted meandifference(WMD)=-0.98(95%CI,-1.83,-0.13), P=0.02]. A lower incidenceof incisional dressing moisture penetration degree of saturation or severe with the non-drainage compared to the drainage[relative risk(RR)=3.27(95%CI,1.41,7.58), P=0.006]. There were no statistically significant differences regarding the rate of postoperative incision infection[RR=0.53(95%CI,0.05,5.76), P=0.60], incidence of incision haematoma, Postoperative neurological damage accidents and the amount of bleeding[WMD=-38.05(95%C1,-84.98,8.87), P=0.11],the Wound dressings moisture penetration degree of incidence of dry[RR=0.67(95%CI,0.39,1.16), P=0.16], the Wound dressings moisture penetration degree of incidence of moderate[RR=1.14(95%CI,0.24,5.46), P=0.87]between the two groups. Conclusion:Based on the current evidence. no obvious evidence to support the application of intraoperative closed drainage.