Effect of drainage versus no drainage after thyroid surgery on wound complications, a meta-analysis

RETRACTION: Effect of Drainage Versus No Drainage after Thyroid Surgery on Wound Complications, a Meta-Analysis

RETRACTION

L. Zhang, Y. Wu, X. Liu, J. Han, and J. Zhao, "Effect of Drainage Versus No Drainage after Thyroid Surgery on Wound Complications, a Meta-Analysis," International Wound Journal 20, no. 10 (2024): 4023-4030, https://doi.org/10.1111/iwj.14291. The above article, published online on 03 July 2023, in Wiley Online Library (http://onlinelibrary.wiley.com/), has been retracted by agreement between the journal Editor in Chief, Professor Keith Harding; and John Wiley & Sons Ltd. Following an investigation by the publisher, all parties have concluded that this article was accepted solely on the basis of a compromised peer review process. The editors have therefore decided to retract the article. The authors did not respond to our notice regarding the retraction.

Practice variations, trends, and outcomes of drain use in thyroidectomy: A NSQIP study

BACKGROUND

The benefit of drains remains unclear and variable among thyroid surgeons. This study examines the utility and trend in drain use after thyroidectomy.

METHOD

This is a retrospective cross-sectional study utilizing a pooled sample of thyroidectomy patients from the 2016-2019 NSQIP. The impact of drain use on outcomes of interest (rate of postoperative neck hematoma (PNH)-primary outcome, and length-of-stay (LOS)-secondary outcome), as well as year-over-year and practice variations were evaluated using inverse-probability-weighted-regression adjustment and multivariable logistic regression analyses.

RESULTS

Of 24,370 patients, 6673(27.4 ​%) received drains. The average LOS and PNH rates were 27.3 ​h and 1.87 %, respectively. Drain use increased year-over-year for concomitant neck dissections (OR ​= ​1.08,p ​= ​0.002). Year-over-year odds of drain use trended down across specialties (OR ​= ​0.96,p ​= ​0.005); however, ENT used drains more frequently than General Surgeons (RR ​= ​3.06, 95%CI ​= ​2.91-3.22). Drains were associated with longer LOS (mean-difference ​= ​9.6hrs, 95%CI 8.51-10.62) with no effect on PNH rates (RR ​= ​0.96,p ​< ​0.05).

CONCLUSION

Drain use is decreasing, but practice variations across specialties persist. Post-thyroidectomy drain use was associated with longer LOS with no effect on PNHR.

Routine Use of Neck Drains Following Thyroid Operations to Prevent Complications Is No Longer Advisable

BACKGROUND

The use of cervical drains to prevent cervical hematoma or seroma after thyroidectomy remains a controversial issue.

OBJECTIVE

Identify clinical and surgical risk factors for hematoma or seroma and evaluate the usefulness of routine use of drains following thyroid surgery.

MATERIAL AND METHODS

The authors conducted a retrospective multicentric study related to consecutive patients submitted to thyroid surgery in seven Portuguese hospitals between January 2018 and December 2020 (n=945). The data collected included the following parameters: age and gender of the patients, anticoagulation or anti-aggregating therapy, histological diagnoses, type of surgery, the presence or absence of postoperative drains, thyroid weight, length of hospital stay, postoperative complications, and reinterventions. In this study, surgical complications evaluated were limited to the presence of hematoma or seroma. A total of 945 patients who underwent thyroid surgery were included in the study. Twenty-seven patients (2.9%, n=27) experienced complications classified as hematomas or seromas. In the series, significant differences were observed between the two groups according to hypocoagulation or anti-aggregation status (OR=3.62; 95% CI 1.14-11.4) (p=0.001) and the nature of histological diagnosis (toxic vs. non-toxic benign disease) (OR=6.59; 95% CI 1.83-23.7). Hypocoagulation or anti-aggregation status were independently associated with a higher risk of complications. The presence of drains was associated with longer hospitalization periods (p<0.001) and not a decreased need for reintervention.

CONCLUSION

Cervical hematoma or seroma are rare complications associated with both hypocoagulation and anti-aggregation therapy and with the presence of benign toxic pathology. The use of drains does not decrease the need for reintervention and is even associated with a longer length of hospital stay; therefore, their routine use should not be advised.

Effect of drainage versus no drainage after thyroid surgery on wound complications, a meta-analysis

A meta-analysis study was used to assess whether not placing a drain after thyroidectomy reduces postoperative wound complications. A critical review of the comprehensive literature up to May 2023 was conducted using four databases: PubMed, Embase, the Cochrane Library, and the web of science. Fourteen interrelated studies were reviewed after passing the inclusion and exclusion criteria established by the study and assessing the quality of the literature.95% confidence intervals (Cl) and odds ratios (OR) were calculated using fixed effects models. The data were meta-analysed using RevMan 5.3 software. The results showed that the use of drains during thyroid surgery did not have a favourable impact on patients. Intraoperative placement of drains did not reduce postoperative wound haematoma formation in patients, (OR, 0.86; 95% CI, 0.54, 1.36 p = 0.52). However, the incidence of postoperative wound infection was significantly higher in patients with drains used in intraoperative thyroid surgery, (OR, 0.22; 95% CI, 0.10, 0.45 p < 0.0001). As the sample size of the randomised controlled study used for this meta-analysis was limited, it is important to approach the findings with caution when interpreting the results.Conducting additional high-quality research with larger sample sizes is crucial in order to further confirm these results and reduce the likelihood of duplication.