title: Wound drains in non-complex lumbar surgery: a systematic review.
abstract: OBJECTIVE
  Our aim was to perform a systematic review of the literature to assess the incidence of post-operative epidural haematomas and wound infections after one-, or two-level, non-complex, lumbar surgery for degenerative disease in patients with, or without post-operative wound drainage.
  
  
  METHODS
  Studies were identified from PubMed and EMBASE, up to and including 27 August 2015, for papers describing one- or two-level lumbar discectomy and/or laminectomy for degenerative disease in adults which reported any form of subcutaneous or subfascial drainage.
  
  
  RESULTS
  Eight papers describing 1333 patients were included. Clinically relevant post-operative epidural haematomas occurred in two (0.15%), and wound infections in ten (0.75%) patients. Epidural haematomas occurred in two (0.47%) patients who had wound drainage (n = 423) and in none of those without wound drainage (n = 910). Wound infections occurred in two (0.47%) patients with wound drainage and in eight (0.88%) patients without wound drainage.
  
  
  CONCLUSIONS
  These data suggest that the routine use of a wound drain in non-complex lumbar surgery does not prevent post-operative epidural haematomas and that the absence of a drain does not lead to a significant change in the incidence of wound infection. Cite this article: Bone Joint J 2016;98-B:984-9.
authors.affiliation: Academic Medical Center, H2-237, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
authors.forename: J L
authors.initials: JL
authors.lastname: Zijlmans
authors.affiliation: Academic Medical Center, H2-237, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
authors.forename: D R
authors.initials: DR
authors.lastname: Buis
authors.affiliation: Academic Medical Center, H2-237, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
authors.forename: D
authors.initials: D
authors.lastname: Verbaan
authors.affiliation: Academic Medical Center, H2-237, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
authors.forename: W P
authors.initials: WP
authors.lastname: Vandertop
mesh_terms: D017586:Diskectomy; D004322:Drainage; D046748:Hematoma, Epidural, Spinal / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D007796:Laminectomy; D008159:Lumbar Vertebrae / Q000601:surgery*; D011182:Postoperative Care; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control*
keywords: Discectomy; Epidural; Haematoma; Laminectomy; Post-operative complications; Post-operative haemorrhage; Spinal; Surgical wound infection; Wound infection