No benefit from post-caesarean wound drainage.
OBJECTIVE
A prospective randomized controlled trial to determine the benefit of caesarean wound drainage in 305 low-risk pregnant women.


METHODS
Pregnant women at low risk of haemorrhage undergoing caesarean section in the Department of Obstetrics, University Hospital, Zurich, between June 1998 and July 1999 were randomised after informed consent into a no-suction group (n = 154) without post-caesarean wound drainage versus a control group with wound drainage (subfascial and subcutaneous) (n = 151). Outcome measures were perioperative decrease in haemoglobin (Hb), postpartum fever (> 38.5 degrees C for > 2 days), sonographic haematoma and other complications requiring revision, cumulative opiate dose adjusted to body weight, length of hospitalisation and operation time.


RESULTS
305 patients completed the study. Decrease in Hb and the rates of fever, haematoma and revision were similar in both groups. However, cumulative opiate dose was lower in the no-suction group (4.5 +/- 1.8 vs 2.8 +/- 1.4 injections, p = 0.0001), and hospital stay was shorter (6.5 +/- 2.4 vs 7.4 +/- 2.8 days, p = 0.0058), as was operation time (32.7 +/- 11.3 v 36.1 +/- 10.5 min; p = 0.0071).


CONCLUSIONS
Routine post-caesarean wound drainage is not only useless but cost-ineffective. In the light of our results, wound drainage may be questioned and should be analysed generally.
Ochsenbein-Imhof
N
N
Department Obstetrics and Gynaecology, University Hospital, Zurich, Switzerland. nadin.ochsenbein-imhof@fhk.usz.ch
Huch
A
A
Huch
R
R
Zimmermann
R
R
D000328:Adult; D000465:Algorithms; D002585:Cesarean Section; D005260:Female; D006441:Hemoglobin A / Q000032:analysis; D006470:Hemorrhage / Q000628:therapy*; D006801:Humans; D007431:Intraoperative Complications / Q000628:therapy*; D011247:Pregnancy; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013396:Suction
D006441:Hemoglobin A