title: Efficacy of closed suction drainage in lower limb arterial surgery: a meta-analysis of published clinical trials.
abstract: BACKGROUND
  Suction drains are widely used in vascular surgery, despite the absence of specific evidence that they confer benefit to patients. There has been no systematic review of the available evidence, though drainage has been shown to confer no benefit, or indeed harm, across a variety of surgical disciplines. Accordingly, a systematic review and meta-analysis of the current evidence base for closed suction drainage following surgical lower limb revascularization was undertaken.
  
  
  METHODS
  Medline, Embase, trial registries, conference proceedings, and article reference lists were searched to identify randomized controlled trials of the use of surgical drains. The primary outcomes were wound infection, seroma/lymphocele formation, and hematoma formation. Pooled odds ratios were calculated for categorical outcomes.
  
  
  RESULTS
  Four trials containing 429 groin wounds were eligible for inclusion. There was no significant effect on wound infection, seroma/lymphocele formation, or hematoma formation.
  
  
  CONCLUSIONS
  Our meta-analysis suggests that no benefit is conferred by wound drainage following lower limb revascularization. The practice incurs avoidable expense and should not be routinely used.
authors.affiliation: Cambridge Vascular Unit, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, United Kingdom.
authors.forename: Alan
authors.initials: A
authors.lastname: Karthikesalingam
authors.forename: Stewart R
authors.initials: SR
authors.lastname: Walsh
authors.forename: Umar
authors.initials: U
authors.lastname: Sadat
authors.forename: Tjun Y
authors.initials: TY
authors.lastname: Tang
authors.forename: Linn
authors.initials: L
authors.lastname: Koraen
authors.forename: Kevin
authors.initials: K
authors.lastname: Varty
mesh_terms: D001158:Arteries / Q000601:surgery; D003362:Cost-Benefit Analysis; D019317:Evidence-Based Medicine; D006406:Hematoma / Q000209:etiology; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D008210:Lymphocele / Q000209:etiology; D016017:Odds Ratio; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D049291:Seroma / Q000209:etiology; D013396:Suction / Q000009:adverse effects / Q000191:economics; D013530:Surgical Wound Infection / Q000209:etiology; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000191:economics