Is there a benefit to drains with a Kocher-Langenbeck approach? A prospective randomized pilot study.
BACKGROUND
Closed suction drainage is a routine part of wound management for patients undergoing surgical treatment of acetabulum fractures. This pilot study seeks to determine if there is a difference in wound healing for a Kocher-Langenbeck approach with and without the use of drains.


METHODS
We conducted a prospective, randomized study including 39 patients with acetabulum fractures treated through a Kocher-Langenbeck approach. During wound closure, patients were randomized into two groups: 20 patients (group I) received drains and 19 (group II) were closed without drains. All were followed up for drain output, quality and quantity of drainage, signs of infection, and duration of drainage. Patients were then evaluated at 2 weeks and 8 weeks for wound healing and any signs of infection.


RESULTS
By the 8-week follow-up, all wounds healed without any signs of infection. There was no difference in the average number of days of drainage between groups: 7.45 days and 7.95 days for group I and group II, respectively (p = 0.37). There were two wound complications (5.13%), with one in each group. Both complications consisted of cellulitis without signs of deep infection and had complete resolution with intravenous antibiotics. A post hoc power analysis determined that a test population of 1,264 patients would be needed to show a reduction in wound drainage time by 1 day.


CONCLUSIONS
With the numbers available in this pilot study, we showed no benefit to the use of drains for acetabular surgery performed through a Kocher-Langenbeck approach.
Hsu
Joseph R
JR
Department of Orthopaedic Surgery, Brooke Army Medical Center, 3851 Roger Brooke Drive, Fort Sam Houston, TX 78234, United States.
Stinner
Daniel J
DJ
Rosenzweig
Seth D
SD
Salinas
Jose
J
Dickson
Kyle F
KF
D000077:Acetabulum / Q000293:injuries*; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000379:methods*; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D011859:Radiography; D013396:Suction; D013530:Surgical Wound Infection / Q000453:epidemiology; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D014945:Wound Healing; D055815:Young Adult