• Adam R Boissonneault, Mara Schenker, Christopher Staley, Madeline Roorbach, Amalie A Erwood, Zachary J Grabel, Thomas Moore, William Reisman, and Michael Maceroli.
• Department of Orthopaedic Surgery, Emory University School of Medicine, 57 Executive Park South, Atlanta, GA, 30329, USA. adam.boissonneault@emory.edu.
• Arch Orthop Trauma Surg. 2019 Jul 1; 139 (7): 907-912.

IntroductionThe purpose of the present study was to evaluate the prevalence of closed suction drainage after a Kocher-Langenbeck (K-L) approach for surgical fixation of acetabular fractures and to determine the impact of closed suction drainage on patient outcomes.MethodsThis retrospective study reports on 171 consecutive patients that presented to a single level I trauma center for surgical fixation of an acetabular fracture. Medical records were reviewed to evaluate the use of closed suction drains. The primary outcomes measures were rate of packed red blood cell (PRBC) transfusion and length of hospital stay (LOS). Secondary outcome measures were 30-day post-operative wound complication and 1-year deep infection rates.ResultsOf the 171 patients included in this study, 140 (82%) patients were treated with drains. There was a significant association between the use of closed suction drainage and post-operative blood transfusion rate (p = 0.002). Thirty-five patients (25%) treated with drains required a post-operative blood transfusion compared to 0% in the no drain cohort. Regarding the total number of drains used, for every additional closed suction drain that was placed beyond a single drain, the odds of receiving a blood transfusion doubled (p = 0.002). Use of closed suction drainage was associated with a significantly longer LOS (p = 0.015), and no difference in wound complication or deep infection rates.ConclusionThe use of closed suction drains for treatment of acetabular fractures using a K-L approach is associated with increased rates of blood transfusion and increased length of hospital stay, with no impact on surgical site infection rates. The results of this study suggest against routine drain usage in acetabular surgery.

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