title: The management of vacuum neck drains in head and neck surgery and the comparison of two different practice protocols for drain removal.
abstract: Introduction The management of vacuum neck drains in head and neck surgery is varied. We aimed to improve early drain removal and therefore patient discharge in a safe and effective manner. Methods The postoperative management of head and neck surgical patients with vacuum neck drains was reviewed retrospectively. A new policy was then implemented to measure drainage three times daily (midnight, 6am, midday). The decision for drain removal was based on the most recent drainage period (at <3ml per hour). A further patient cohort was subsequently assessed prospectively. The length of hospital stay was compared between the cohorts. Results The retrospective audit included 51 patients while the prospective audit included 47. The latter saw 16 patients (33%) discharged at least one day earlier than they would have been under the previous policy. No adverse effects were noted from earlier drain removal. Conclusions Measuring drainage volumes three times daily allows for more accurate assessment of wound drainage, and this can lead to earlier removal of neck drains and safe discharge.
authors.affiliation: Department of Otolaryngology, Head & Neck Surgery, Aintree University Hospital NHS Foundation Trust , UK.
authors.forename: A V
authors.initials: AV
authors.lastname: Kasbekar
authors.affiliation: Department of Otolaryngology, Head & Neck Surgery, Aintree University Hospital NHS Foundation Trust , UK.
authors.forename: F
authors.initials: F
authors.lastname: Davies
authors.affiliation: Department of Otolaryngology, Head & Neck Surgery, Aintree University Hospital NHS Foundation Trust , UK.
authors.forename: N
authors.initials: N
authors.lastname: Upile
authors.affiliation: Leeds Teaching Hospitals NHS Trust and Bradford Institute of Health Research , UK.
authors.forename: M W
authors.initials: MW
authors.lastname: Ho
authors.affiliation: Department of Otolaryngology, Head & Neck Surgery, Aintree University Hospital NHS Foundation Trust , UK.
authors.forename: N J
authors.initials: NJ
authors.lastname: Roland
mesh_terms: D000328:Adult; D000368:Aged; D054869:Clinical Audit; D020878:Device Removal / Q000379:methods*; D019468:Disease Management; D004322:Drainage / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000295:instrumentation*; D011182:Postoperative Care / Q000379:methods*; D011446:Prospective Studies; D013997:Time Factors
keywords: Drainage; Head and neck surgery