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Drainless head and neck surgery: A retrospective review of 156 procedures (thyroidectomy, parotidectomy and neck dissections in a tertiary setting)

Percutaneous drains are frequently used in head and neck surgery cases. However, although effective at preventing postoperative haematoma formation their use can also be associated with significant complications, including infection, fistulae, pain, psychosocial implications, and most notably prolongation of hospital stay. As such, some authors have advocated approaches to minimise or avoid the use of percutaneous drains altogether, mainly through the use of surgical adjuncts such as fibrin glue to 'stick down' flaps preventing fluid/blood accumulating; pressure dressings to minimise the risk of haematoma formation; or consideration of early drain removal to facilitate expedited hospital discharge. Some authors are beginning to advocate drainless techniques without the use of advanced dressings or glues, typically thyroid surgery in selected cases. Indeed, meta-analyses of thyroid and parathyroid surgery have demonstrated no significant difference in complication rates between the routine use of drains and patients managed without. However to our knowledge there are currently no studies examining complete drainless Head and Neck surgery. To this end, this case series examines 156 consecutive head and neck surgical procedures undertaken within a tertiary centre without the traditional use of percutaneous drains or any associated adjuncts.