No benefit when placing drains after kidney transplant: a complex statistical analysis.
OBJECTIVE
This paper sought to determine if there were an association between drain placement and the incidence of wound complications.


METHODS
A single-center institutional review board-approved retrospective study between 2001 to 2008, comparing 680 kidney transplant patients who either had a drain placed or were left undrained. Linear regression modeling was used to adjust the risk factors between the groups. Patients received calcineurin inhibitors, steroids, and a mycophenolate formulation. The incidence of early major and minor wound complications were captured. Minor wound complications were defined as seroma, lymphocele, and perigraft fluid collection, and major wound complications were defined as wound dehiscence, hematomas, evisceration, infections, wound necrosis, and hernias. Patients with incomplete data or those taking sirolimus were excluded.


RESULTS
Six hundred eighty kidney transplant cases were reviewed. Four hundred seventy-nine received drains; 201 did not. Demographic analyses revealed that the drain group had a higher average value in age and body mass index. The drain group had a lower albumin and a lower mean platelet count after surgery. The number of patients without diabetes in the drain group numbered nearly twice as many as did those without drains. An attempt was made to statistically account for demographic differences. Seventy-eight of 479 drained patients (16.28%) and 24 of 201 no-drain patients (11.94%) had a wound complication. Minor wound complications were observed in 9 patients (1.88%) in the drain group and 6 in no-drain group (2.99%) (P = .3702). Major wound complications were observed in 58 patients in the drain group (12.18%) and 17 in the no-drain group (8.46%) (P = .1655). Drain placement had no effect on major or minor wound complications.


CONCLUSIONS
Drain placement is not associated with major or minor wound complications in kidney transplants.
Albert Einstein Medical Center, Philadelphia, PA, USA.
Ryan C
RC
Sidebottom
Afshin
A
Parsikia
Po-Nan
PN
Chang
Zekarias
Z
Berhane
Stalin
S
Campos
Kamran
K
Khanmoradi
Radi F
RF
Zaki
Jorge A
JA
Ortiz
D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003627:Data Interpretation, Statistical; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015143:Philadelphia / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control*; D057216:Propensity Score; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014945:Wound Healing
D007166:Immunosuppressive Agents