Wound Routine Drainage after Thyroid and Parathyroid Surgery: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

WANG Shangqian ,  SHAO Guoan , HU Xuejun , ZHANG Hu , LIU Guifeng

Cancer Diagnosis & Treatment Center of the Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, China;

Corresponding author：

SHAO Guoan, Email: gzbdz@tom.com

Keywords：

Thyroid; Parathyroid; Drainage; Systematic review; Meta-analysis; Randomzed controlled trial

DOI：

10.7507/1672-2531.20120127

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective 　To learn the postoperative wound complications of thyroid and parathyroid, respiratory complications, duration of hospital stay and postoperative mortality, so as to further clarify the clinical effectiveness of placing drainage tube after thyroid and parathyroid surgery.
Methods 　The following databases as The Cochrane Library, MEDLINE, EMbase, SCI and CNKI were retrieved orderly from the date of their establishment to March 29th, 2011. The literature was screened strictly according to inclusive criteria, included studies were analyzed using RevMan5.1.2 software, and the evidence levels of all indicators were evaluated using GRADEpro 3.5.1 software.
Results 　A total of 16 studies involving 1 907 participants were included. There was no high-quality literature. No case reports of death and respiratory distress syndrome. Comparing the drainage group with the non-drainage group among the 16 studies, no significant difference was found in the incidence of re-operation, wound hematoma/seroma, wound infection and subcutaneous fluids. Incision pain score was significantly different between the two groups (RR=2.15, 95%CI 1.10 to –4.23, P=0.03); and the duration of hospital stay was significantly prolonged in the drainage group (SMD=0.79, 95%CI 0.38 to –1.20, I2=93%, P=0.000 2).
Conclusion 　The evidence shows that drainage after thyroid and parathyroid surgery can not significantly reduce the incidence of postoperative complications; but increase the duration of hospital stay. Current evidence is based on the circumstance of non-substernal goiter surgery, normal coagulation indexes and non neck lymphadenectomy, which does not apply to the conclusion of this study. It is suggested that this issue should be further studied in the future due to the lack of high-quality, multi-center and large-scale RCTs.

Citation： WANG Shangqian,SHAO Guoan,HU Xuejun,ZHANG Hu,LIU Guifeng. Wound Routine Drainage after Thyroid and Parathyroid Surgery: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2012, 12(7): 830-839. doi: 10.7507/1672-2531.20120127 Copy

1.	Yeung MJ, Serpell JW. Management of the solitary thyroid nodule.Oncologist, 2008, 13(2): 105-112.
2.	Tae HJ, Lim DJ, Baek KH, et al. Diagnostic value of ultrasonography to distinguish between benign and malignant lesions in the management of thyroid nodules. Thyroid, 2007, 17(5): 461-466.
3.	Dean DS, Gharib H. Epidemiology of thyroid nodules. Best Pract Res Clin Endo crinol Metab, 2008, 22(6): 901-911.
4.	Schneider AB, Bekerman C, Lelang J, et al. Thyroid nodules in the follow-up of irra diated individuals: comparison of thyroid ultrasound with scanning and palpation. Clin Endocrinol Metab, 1997, 82: 4020-4027.
5.	Lundgren E, Rastad J, Thurfjell E, et al. Population-based screening for primary hyper parathyroidism with serum calcium and parathyroid hormone values in menopausal women. Surgery, 1997, 121: 287-294.
6.	Herranz J, Latorre J. [Drainage in thyroid and parathyroid surgery]. J Acta Otorrino- laringol Esp, 2007, 58(1): 7-9.
7.	Bergamaschi R, Becouam G, Ronceray J, et al. Morbidity of thyroid surgery. J Am J Surg, 1998, 176(1): 71-75.
8.	Kennedy SA, Irvine RA, Westerberg BD, et al. Meta-analysis: prophylactic drainage and bleeding complications in thyroid surgery. J Otolaryngol Head Neck Surg, 2008, 37(6): 768-773.
9.	Shandilya M, Kieran S, Walshe P, et al. Cervical haematoma after thyroid surgery. Management and Prevention, 2006, 99(9): 266-268.
10.	Colak T, Akca T, Turkmenoglu O, et al. Drainage after total thyroidectomy or lobectomy for benign thyroidal disorders. J Zhejiang Univ Sci B, 2008, 9(4): 319-323.
11.	Harding J, Sebag F, Sierra M, et al. Thyroid surgery: Postoperative hemato-ma– prevention and treatment. Langenbecks Arch Surg, 2006, 391: 169-173.
12.	Abbas G, Dubner S, Heller KS. Re-operation for bleeding after thyroidectomy and parathyroidectomy. Head and Neck, 2001, 23(7): 544-546.
13.	Ardito G, Revelli L, Guidi ML, et al. [Drainage in thyroid surgery].Annali Italiani di Chirugia, 1999, 70(4): 511-517.
14.	Daou R. [Thyroidectomy without drainage]. Chirurgie,memoires dr l’Academie de chirugie, 1997, 122(7): 408-410.
15.	Palestini N, Tulletti V, Cestino L, et al. [Post-thyroidectomy cervical hematoma]. Minerva Chirurgica, 2005, 60(1): 37-46.
16.	Shaha AR, Jaffe BM. Practical management of post-thyroidectomy hematoma. Journal of Surgical Oncology, 1994, 57(4): 235-238.
17.	Willy C, Steinbronn S, Sterk J, et al. Drainage systems in thyroid surgery: a randomized trial of passive and suction drainage. European Journal of Surgery, 1998, 164(12): 935-940.
18.	Ernst R, Wiemer C, Rembs E, et al. Local effects and changes in wound drainage in the free peritoneal cavity. Langenbecks Archiv fur Chirugie, 1997, 382(6): 380-392.
19.	Mannell C. Respiratory obstruction after thyroidectomy. A report of 2 cases. South African Journal of Surgery, 1989, 27(4): 141-143.
20.	Martis C, Athanassiades S. Post-thyroidectomy laryngeal edema. A survey of fifty- four cases. Amercian Journal of Surgery, 1971, 122(1): 58-60.
21.	Tabaqchali MA, Hanson JM, Proud G. Drains for thyroidectomy/ parathyroidectomy: fact or fiction?. J Ann R Goll Surg Engl, 1999, 81(5): 302-305.
22.	Was MK, Valiulis AP, Hurst MK. Drains in thyroid and parathyroid surgery.Are they necessary?. J Arch Otolaryngol Head Neck Surg, 1995, 121(9): 981-983.
23.	Shaha AR, Jaffe BM. Selective use of drains in thyroid surgery. J Surg Oncol, 1993, 52(4): 241-243.
24.	Debry C, Renou G, Fingerhut A. Drainage after thyroid surgery: a prospective randomized study. J Laryngol Otol, 1999, 113(1): 49-51.
25.	Musa AA, Agboola OJ, Banjo AA, et al. The use of drains in thyroid surgery. J Niger postgrad Med J, 2010, 17(1): 15-18.
26.	Suslu N, Vural S, Oncel M, et al. Is the insertion of drains after uncomplicated thyroid surgery always necessary?. J Surg Tody, 2006, 36(3): 215-218.
27.	Peix JL, Teboul F, Feldman H, et al. Drainage after thyroidectomy: a randomized clinical trial. J Int Surg, 1992, 77(2): 122-124.
28.	Ahluwalia S, Hannan SA, Mehrzad H, et al. A randomized controlled trial of routine suction drainage after elective thyroid and parathyroid surgery with ultrasound evaluation of fluid collection. J Clin Otolaryngol, 2007, 32(1): 28-31.
29.	Tubergen D, Moning E, Richter A, et al. [Assessment of drain insertion in thyroid sur- gery?]. J Zentralbl Chir, 2001, 126(12): 960-963.
30.	Schoretsanitis G, Melissas J, Sanidas E, et al. Does draining the neck affect morbidity following thyroid surgery?. J AM Surg, 1998, 64(8): 778-780.
31.	Sanabria A, Carvalho AL, Silver CE, et al. Routine drainage after thyroid surgery-a meta-analysis. J Surg Oncol, 2007, 96(3): 273-280.
32.	Khanna J, Mohil RS, Chintamani, et al. Is the routine drainage after surgery for thyroid necessary? A prospective randomized clinical study [ISRCTN63623153]. J BMC Surg, 2005, 5(1): 11.
33.	Dotzenrath Cm, Cupisti K, Raffel A, et al. Do Germans keep patients too long in hospital? A prospective randomized trial. World J Surg, 2005, 29(9): 1189-1193.
34.	Collis N, Mcguiness CM, Batchelor AG. Drainage in brest reduction surgery: a pro- spective randomized intra-patient trail. J British Journal of Plastic Surgery, 2005, 58(3): 286-289.
35.	Pothier DD. The use of drains following thyroid and parathyroid surgery: a meta- annlysis. J Laryngol otol, 2005, 119(9): 669-671.
36.	Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews for Inter- ventions 5.1.2 [updated March 2011]. http://www.cochrane.org/resources/ handbook /hbook.htm (accessed 2011).
37.	Macaskill P, Walter SD, Irwig L. A comparison of methods to detect publication bias in meta-analysis. Statistics in Medicine, 2001, 20(4): 641-654.
38.	Pietrzak WS, Yoo J. Evaluation of postoperative drainage with application of platelet- rich and platelet-poor plasma after hemithyroidectomy: A randomized controlled clinical trial. Journal of Craniofacial Surgery, 2009, 20(3): 978-979.
39.	Yoo J, Roth K, Hughes B, et al. Evaluation of Postoperative drainage with application of platelet-rich and platelet-poor plasma following hemithyroidectomy: a randomized controlled clinical trial. Head Neck, 2008, 30(12): 1552-1558.
40.	Uwiera TC, Uwiera RR, Seikaly H, et al. Tisseel and its effects on wound drainage post-thyroidectomy: prospective,randomized, blinded, controlled study. J Otolaryngol, 2005, 34(6): 374-378.
41.	Harris JR, Uwiera T, Seikaly H. Tisseel to reduce post thyroidectomy wound drainage: a randomized prospective clinical trial. International Conference on Head and Neck Cancer, 2004, 8: 7-11.
42.	Duonigi G, Boni L, Rovera F, et al. Wound morbidity in mini-invasive thyroidectomy. Surgical Endoscopy and Other Interventional Techniques, 2011, 25(1): 62-67.
43.	Ditzenrath CM, Cupisti K, Raffel A, et al. Do Germans keep patients too long in hospital? A prospective randomized trial. World J Surg, 2005, 29(9): 1189-1193.
44.	Avebia N, Sanguinetti A, Cirocchi R, et al. Antibiotic prophylaxis in thyroid surgery: a preliminary multicentric Italian experience. Ann Surg Innov Res, 2009, Aug 5, 3: 10.
45.	顾爱莲, 舟欢. 两种负压引流装置用于甲状腺术后引流的效果比较. 解放军护理杂志, 2010, 27(2A): 232-233.
46.	刘敏. 甲状腺次全切除术不同引流方法效果评价. 医学信息, 2011, 2: 424-424.
47.	Liardo G, Debry C, Renou G. The role of drainage in thyroid surgery-Preliminary results of a randomized trial. Endocrinology & Metabolism Surgery, 1994, 12: 181- 184.
48.	Neary PM, O’Connor OJ, Shafiq A, et al. Can we abandon using drains following thyroid surgery? -a prospective randomized clinical study. Irish Journal of Medical Science, 2009, Sept: 4-5.
49.	Dimov R, Ali M,Uchikov A, et al. [Drainage in thyroid surgery-prospective randomized study]. Khirurgiia (Sofiia), 2006, (2): 28-30.
50.	Mok Co, King WWK, Paterson-Brown S, et al. Suction drainage after thyroidectomy is it necessary?. Third International Conference on Head and Neck cancer, San Francisco. San Francisco, 1992.
51.	De Salvo L, Razzetta F, Tassone U, et al. [The role of drainage and antibiotic prophylaxis in thyroid surgery]. Minerva Chirurgica, 1998, 53(11): 895-898.
52.	Pezzullo L, Chiofalo MG, Caraco C, et al. Drainage in thyroid surgery: a prospective randomized clinical study. Chir Ital, 2001, 53(3): 345-347.
53.	Giovannini C, De Milito R, Pronio A, et al. Use of drainage in thyroid surgery. Chirurgia, 1999, 12(6): 419-421.
54.	De Salvo L, Arezzo A, Razzetta F, et al. [Connection between the type of drainage and sepisis in thyroid surgery]. Ann Ital Chir, 1998, 69(2): 165-167.
55.	Ayyash K, Khammash M, Tibblin S. Drain vs. no drain in primary thyroid and para- thyroid surgery. Eur J Surg, 1991, 157(2): 113-114.
56.	Kristoffersson A, Sandzen B, Jarhult J. Drainage in uncomplicated thyroid and parathyroid surgery. Br J Surg, 1986, 73(2): 121-122.
57.	Wihlborg O, Bergljung L, Martensson H. To drain or not to drain in thyroid surgery. A controlled clinical study. Arch Surg, 1988, 123(1): 40-41.
58.	Hurtado-Lopez LM, Lopez-Romero S, Rizzo-Fuentes C, et al. Selective use of drains in thyroid surgery. Head Neck, 2001, 23(3): 189-193.
59.	Lee SW, Choi EC, Lee YM, et al. Is lack of placement of drains after thyroidectomy with central neck dissection safe? A prospective, randomized study. Laryngoscope, 2006, 116(9): 1632-1635.
60.	Schwarz W, Willy C, Ndjee C. [Gravity or suction drainage in thyroid surgery? Control of efficacy with ultrasound determination of residual hematoma]. Langenbecks Archiv fur Chirurgie, 1996, 381(6): 337-342.
61.	Teboul F, Peix JL, Guibaud L, et al. [Prophylactic drainage after thyroidectomy: a ran- domized trial]. Annales de Chirurgie, 1992, 46(10): 902-904.
62.	Morrissey AT, Chau J, Yunker WK, et al. Comparison of drain versus no drain thyroid- dectomy: randomized prospective clinical trial. J Otolaryngol Head Neck Surg, 2008, 37(1): 43-47.
63.	Brudermanns B, Teymoortash A, Neumann HJ. Routine suction drainage after thyroid and parathyroid surgery is not necessary.Laryngo-Rhino-Otologie, 2007, 86(8): 560-561.
64.	Corsten M, Johnson S, Alherabi A. Is suction drainage an effective means of preventing hematoma in thyroid surgery? A meta-analysis. J Otolaryngol, 2005, 34(6): 415-417.
65.	Samraj K, Gurusamy KS. Wound drains following thyroid surgery.Cochrane Database Syst Rev, 2007, 17(4): CD006099.

1. Yeung MJ, Serpell JW. Management of the solitary thyroid nodule.Oncologist, 2008, 13(2): 105-112.
2. Tae HJ, Lim DJ, Baek KH, et al. Diagnostic value of ultrasonography to distinguish between benign and malignant lesions in the management of thyroid nodules. Thyroid, 2007, 17(5): 461-466.
3. Dean DS, Gharib H. Epidemiology of thyroid nodules. Best Pract Res Clin Endo crinol Metab, 2008, 22(6): 901-911.
4. Schneider AB, Bekerman C, Lelang J, et al. Thyroid nodules in the follow-up of irra diated individuals: comparison of thyroid ultrasound with scanning and palpation. Clin Endocrinol Metab, 1997, 82: 4020-4027.
5. Lundgren E, Rastad J, Thurfjell E, et al. Population-based screening for primary hyper parathyroidism with serum calcium and parathyroid hormone values in menopausal women. Surgery, 1997, 121: 287-294.
6. Herranz J, Latorre J. [Drainage in thyroid and parathyroid surgery]. J Acta Otorrino- laringol Esp, 2007, 58(1): 7-9.
7. Bergamaschi R, Becouam G, Ronceray J, et al. Morbidity of thyroid surgery. J Am J Surg, 1998, 176(1): 71-75.
8. Kennedy SA, Irvine RA, Westerberg BD, et al. Meta-analysis: prophylactic drainage and bleeding complications in thyroid surgery. J Otolaryngol Head Neck Surg, 2008, 37(6): 768-773.
9. Shandilya M, Kieran S, Walshe P, et al. Cervical haematoma after thyroid surgery. Management and Prevention, 2006, 99(9): 266-268.
10. Colak T, Akca T, Turkmenoglu O, et al. Drainage after total thyroidectomy or lobectomy for benign thyroidal disorders. J Zhejiang Univ Sci B, 2008, 9(4): 319-323.
11. Harding J, Sebag F, Sierra M, et al. Thyroid surgery: Postoperative hemato-ma– prevention and treatment. Langenbecks Arch Surg, 2006, 391: 169-173.
12. Abbas G, Dubner S, Heller KS. Re-operation for bleeding after thyroidectomy and parathyroidectomy. Head and Neck, 2001, 23(7): 544-546.
13. Ardito G, Revelli L, Guidi ML, et al. [Drainage in thyroid surgery].Annali Italiani di Chirugia, 1999, 70(4): 511-517.
14. Daou R. [Thyroidectomy without drainage]. Chirurgie,memoires dr l’Academie de chirugie, 1997, 122(7): 408-410.
15. Palestini N, Tulletti V, Cestino L, et al. [Post-thyroidectomy cervical hematoma]. Minerva Chirurgica, 2005, 60(1): 37-46.
16. Shaha AR, Jaffe BM. Practical management of post-thyroidectomy hematoma. Journal of Surgical Oncology, 1994, 57(4): 235-238.
17. Willy C, Steinbronn S, Sterk J, et al. Drainage systems in thyroid surgery: a randomized trial of passive and suction drainage. European Journal of Surgery, 1998, 164(12): 935-940.
18. Ernst R, Wiemer C, Rembs E, et al. Local effects and changes in wound drainage in the free peritoneal cavity. Langenbecks Archiv fur Chirugie, 1997, 382(6): 380-392.
19. Mannell C. Respiratory obstruction after thyroidectomy. A report of 2 cases. South African Journal of Surgery, 1989, 27(4): 141-143.
20. Martis C, Athanassiades S. Post-thyroidectomy laryngeal edema. A survey of fifty- four cases. Amercian Journal of Surgery, 1971, 122(1): 58-60.
21. Tabaqchali MA, Hanson JM, Proud G. Drains for thyroidectomy/ parathyroidectomy: fact or fiction?. J Ann R Goll Surg Engl, 1999, 81(5): 302-305.
22. Was MK, Valiulis AP, Hurst MK. Drains in thyroid and parathyroid surgery.Are they necessary?. J Arch Otolaryngol Head Neck Surg, 1995, 121(9): 981-983.
23. Shaha AR, Jaffe BM. Selective use of drains in thyroid surgery. J Surg Oncol, 1993, 52(4): 241-243.
24. Debry C, Renou G, Fingerhut A. Drainage after thyroid surgery: a prospective randomized study. J Laryngol Otol, 1999, 113(1): 49-51.
25. Musa AA, Agboola OJ, Banjo AA, et al. The use of drains in thyroid surgery. J Niger postgrad Med J, 2010, 17(1): 15-18.
26. Suslu N, Vural S, Oncel M, et al. Is the insertion of drains after uncomplicated thyroid surgery always necessary?. J Surg Tody, 2006, 36(3): 215-218.
27. Peix JL, Teboul F, Feldman H, et al. Drainage after thyroidectomy: a randomized clinical trial. J Int Surg, 1992, 77(2): 122-124.
28. Ahluwalia S, Hannan SA, Mehrzad H, et al. A randomized controlled trial of routine suction drainage after elective thyroid and parathyroid surgery with ultrasound evaluation of fluid collection. J Clin Otolaryngol, 2007, 32(1): 28-31.
29. Tubergen D, Moning E, Richter A, et al. [Assessment of drain insertion in thyroid sur- gery?]. J Zentralbl Chir, 2001, 126(12): 960-963.
30. Schoretsanitis G, Melissas J, Sanidas E, et al. Does draining the neck affect morbidity following thyroid surgery?. J AM Surg, 1998, 64(8): 778-780.
31. Sanabria A, Carvalho AL, Silver CE, et al. Routine drainage after thyroid surgery-a meta-analysis. J Surg Oncol, 2007, 96(3): 273-280.
32. Khanna J, Mohil RS, Chintamani, et al. Is the routine drainage after surgery for thyroid necessary? A prospective randomized clinical study [ISRCTN63623153]. J BMC Surg, 2005, 5(1): 11.
33. Dotzenrath Cm, Cupisti K, Raffel A, et al. Do Germans keep patients too long in hospital? A prospective randomized trial. World J Surg, 2005, 29(9): 1189-1193.
34. Collis N, Mcguiness CM, Batchelor AG. Drainage in brest reduction surgery: a pro- spective randomized intra-patient trail. J British Journal of Plastic Surgery, 2005, 58(3): 286-289.
35. Pothier DD. The use of drains following thyroid and parathyroid surgery: a meta- annlysis. J Laryngol otol, 2005, 119(9): 669-671.
36. Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews for Inter- ventions 5.1.2 [updated March 2011]. http://www.cochrane.org/resources/ handbook /hbook.htm (accessed 2011).
37. Macaskill P, Walter SD, Irwig L. A comparison of methods to detect publication bias in meta-analysis. Statistics in Medicine, 2001, 20(4): 641-654.
38. Pietrzak WS, Yoo J. Evaluation of postoperative drainage with application of platelet- rich and platelet-poor plasma after hemithyroidectomy: A randomized controlled clinical trial. Journal of Craniofacial Surgery, 2009, 20(3): 978-979.
39. Yoo J, Roth K, Hughes B, et al. Evaluation of Postoperative drainage with application of platelet-rich and platelet-poor plasma following hemithyroidectomy: a randomized controlled clinical trial. Head Neck, 2008, 30(12): 1552-1558.
40. Uwiera TC, Uwiera RR, Seikaly H, et al. Tisseel and its effects on wound drainage post-thyroidectomy: prospective,randomized, blinded, controlled study. J Otolaryngol, 2005, 34(6): 374-378.
41. Harris JR, Uwiera T, Seikaly H. Tisseel to reduce post thyroidectomy wound drainage: a randomized prospective clinical trial. International Conference on Head and Neck Cancer, 2004, 8: 7-11.
42. Duonigi G, Boni L, Rovera F, et al. Wound morbidity in mini-invasive thyroidectomy. Surgical Endoscopy and Other Interventional Techniques, 2011, 25(1): 62-67.
43. Ditzenrath CM, Cupisti K, Raffel A, et al. Do Germans keep patients too long in hospital? A prospective randomized trial. World J Surg, 2005, 29(9): 1189-1193.
44. Avebia N, Sanguinetti A, Cirocchi R, et al. Antibiotic prophylaxis in thyroid surgery: a preliminary multicentric Italian experience. Ann Surg Innov Res, 2009, Aug 5, 3: 10.
45. 顾爱莲, 舟欢. 两种负压引流装置用于甲状腺术后引流的效果比较. 解放军护理杂志, 2010, 27(2A): 232-233.
46. 刘敏. 甲状腺次全切除术不同引流方法效果评价. 医学信息, 2011, 2: 424-424.
47. Liardo G, Debry C, Renou G. The role of drainage in thyroid surgery-Preliminary results of a randomized trial. Endocrinology & Metabolism Surgery, 1994, 12: 181- 184.
48. Neary PM, O’Connor OJ, Shafiq A, et al. Can we abandon using drains following thyroid surgery? -a prospective randomized clinical study. Irish Journal of Medical Science, 2009, Sept: 4-5.
49. Dimov R, Ali M,Uchikov A, et al. [Drainage in thyroid surgery-prospective randomized study]. Khirurgiia (Sofiia), 2006, (2): 28-30.
50. Mok Co, King WWK, Paterson-Brown S, et al. Suction drainage after thyroidectomy is it necessary?. Third International Conference on Head and Neck cancer, San Francisco. San Francisco, 1992.
51. De Salvo L, Razzetta F, Tassone U, et al. [The role of drainage and antibiotic prophylaxis in thyroid surgery]. Minerva Chirurgica, 1998, 53(11): 895-898.
52. Pezzullo L, Chiofalo MG, Caraco C, et al. Drainage in thyroid surgery: a prospective randomized clinical study. Chir Ital, 2001, 53(3): 345-347.
53. Giovannini C, De Milito R, Pronio A, et al. Use of drainage in thyroid surgery. Chirurgia, 1999, 12(6): 419-421.
54. De Salvo L, Arezzo A, Razzetta F, et al. [Connection between the type of drainage and sepisis in thyroid surgery]. Ann Ital Chir, 1998, 69(2): 165-167.
55. Ayyash K, Khammash M, Tibblin S. Drain vs. no drain in primary thyroid and para- thyroid surgery. Eur J Surg, 1991, 157(2): 113-114.
56. Kristoffersson A, Sandzen B, Jarhult J. Drainage in uncomplicated thyroid and parathyroid surgery. Br J Surg, 1986, 73(2): 121-122.
57. Wihlborg O, Bergljung L, Martensson H. To drain or not to drain in thyroid surgery. A controlled clinical study. Arch Surg, 1988, 123(1): 40-41.
58. Hurtado-Lopez LM, Lopez-Romero S, Rizzo-Fuentes C, et al. Selective use of drains in thyroid surgery. Head Neck, 2001, 23(3): 189-193.
59. Lee SW, Choi EC, Lee YM, et al. Is lack of placement of drains after thyroidectomy with central neck dissection safe? A prospective, randomized study. Laryngoscope, 2006, 116(9): 1632-1635.
60. Schwarz W, Willy C, Ndjee C. [Gravity or suction drainage in thyroid surgery? Control of efficacy with ultrasound determination of residual hematoma]. Langenbecks Archiv fur Chirurgie, 1996, 381(6): 337-342.
61. Teboul F, Peix JL, Guibaud L, et al. [Prophylactic drainage after thyroidectomy: a ran- domized trial]. Annales de Chirurgie, 1992, 46(10): 902-904.
62. Morrissey AT, Chau J, Yunker WK, et al. Comparison of drain versus no drain thyroid- dectomy: randomized prospective clinical trial. J Otolaryngol Head Neck Surg, 2008, 37(1): 43-47.
63. Brudermanns B, Teymoortash A, Neumann HJ. Routine suction drainage after thyroid and parathyroid surgery is not necessary.Laryngo-Rhino-Otologie, 2007, 86(8): 560-561.
64. Corsten M, Johnson S, Alherabi A. Is suction drainage an effective means of preventing hematoma in thyroid surgery? A meta-analysis. J Otolaryngol, 2005, 34(6): 415-417.
65. Samraj K, Gurusamy KS. Wound drains following thyroid surgery.Cochrane Database Syst Rev, 2007, 17(4): CD006099.

Chinese Journal of Evidence-Based Medicine

Wound Routine Drainage after Thyroid and Parathyroid Surgery: A Systematic Review

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