title: Improved Intermittent-clamped Drainage in Lower Lumbar Internal Fixation: A Randomized Prospective Study.
abstract: BACKGROUND
  Continuous negative pressure drainage (CNPD) is widely used after lower lumbar internal fixation; however, it may cause tremendous blood loss and lead to postoperative hemorrhagic anemia. The present study explored the efficacy and safety of improved intermittent-clamped drainage (ICD) for lower lumbar internal fixation.
  
  
  METHODS
  This was a prospective study that included 156 patients with decompression of the spinal canal and internal fixation for the first time from January 2012 to December 2014. The patients were randomly divided into ICD group and CNPD group, and each group had 78 cases. A drainage tube was placed under the deep fascia in all patients within 10 min after the commencement of wound closure. The postoperative drainage amount at different time points, the hemoglobin level, and postoperative complications were recorded and compared between the two groups. Shapiro-Wilk test, independent samples t-test, and Mann-Whitney U-test were used in this study.
  
  
  RESULTS
  The drainage amount was significantly reduced in the ICD group, as compared with the CNPD group (Z = 10.74, P < 0.01). The mean total drainage amount (in ml) of the single-segment and two-segment procedures was significantly greater in the CNPD group than the ICD group (Z = 10.63 and 10.75, respectively; P < 0.01). For the adverse events, there was no significant difference in postoperative temperature, wound problem, and complications between the two groups.
  
  
  CONCLUSIONS
  The present study showed a statistically significant reduction in postoperative drainage amount between ICD and CNPD groups, and ICD is an effective, convenient, and safe method for routine use in lower lumbar surgery. It is essential to focus on the effect of clamping drainage with long-segment surgical procedure and complex lumbar disease in the further investigation, as well as the effect of clamping on long-term functional outcomes.
authors.affiliation: Department of Spinal Surgery, -Japan Friendship Hospital, Beijing 100029, China.
authors.forename: Qing-Ying
authors.initials: QY
authors.lastname: Hao
authors.affiliation: Graduate School, Beijing University of Chinese Medicine, Beijing 100029, China.
authors.forename: Chu-Yin
authors.initials: CY
authors.lastname: Liu
authors.affiliation: Department of Spinal Surgery, -Japan Friendship Hospital, Beijing 100029, China.
authors.forename: Chan-Juan
authors.initials: CJ
authors.lastname: Fu
authors.affiliation: Department of Spinal Surgery, -Japan Friendship Hospital, Beijing 100029, China.
authors.forename: Xiao-Hua
authors.initials: XH
authors.lastname: Zhang
authors.affiliation: Department of Spinal Surgery, -Japan Friendship Hospital, Beijing 100029, China.
authors.forename: Ming-Sheng
authors.initials: MS
authors.lastname: Tan
mesh_terms: D016063:Blood Loss, Surgical / Q000517:prevention & control; D004322:Drainage / Q000379:methods; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013123:Spinal Fusion / Q000379:methods; D016896:Treatment Outcome