Postoperative Drain Use in Cranial Vault Remodeling: A Survey of Craniofacial Surgeon Practices and a Review of the Literature

Diana S. Jodeh, Nima Khavanin, James J. Cray, Gerald F. Tuite, Jordan P. Steinberg, S. Alex Rottgers

Research output: Contribution to journalArticle

Abstract

Background: The use of subgaleal drains following primary cranioplasty for craniosynostosis has undergone limited investigation. Proposed benefits include prevention of seroma, detection of postoperative bleeding, and cerebrospinal fluid leak. We conducted a systematic review of the literature and surveyed craniofacial surgeons to ascertain the current evidence pertaining to drain use following primary cranioplasty for craniosynostosis and to determine surgical practice patterns. Methods: PubMed and Embase databases were searched to identify relevant articles. Abstracts were reviewed by 2 investigators, and a Cohen κ statistic was calculated. Patient demographic and outcome data were extracted and compared. A 9-question survey was e-mailed to active and associate members of the American Society of Craniofacial Surgeons. Results: A total of 7395 unique citations were identified. Only 2 retrospective chart reviews met inclusion criteria. All objective parameters demonstrated no difference between patients with and without drains. A subjective benefit of limiting facial swelling was proposed without objective analysis. Fifty (32.5%) of the 154 craniofacial surgeons responded to the survey. Forty-two percent used postoperative drains. A significant association (P =.01) was found between the belief that drains limited facial swelling and their use. Conclusions: The literature examining postoperative drain use in primary cranioplasty for craniosynostosis is restricted. The current studies show no definite benefit to drain use but are limited in their assessment of key outcomes. There is wide variability among surgeons regarding drain use, and this seems to be motivated by belief and tradition.

Original languageEnglish (US)
Pages (from-to)1001-1007
Number of pages7
JournalCleft Palate-Craniofacial Journal
Volume56
Issue number8
DOIs
StatePublished - Sep 1 2019

Fingerprint

Craniosynostoses
Seroma
PubMed
Research Personnel
Demography
Outcome Assessment (Health Care)
Databases
Hemorrhage
Surveys and Questionnaires
Surgeons

Keywords

  • craniofacial growth
  • craniofacial morphology
  • surgical complications

ASJC Scopus subject areas

  • Oral Surgery
  • Otorhinolaryngology

Cite this

Postoperative Drain Use in Cranial Vault Remodeling : A Survey of Craniofacial Surgeon Practices and a Review of the Literature. / Jodeh, Diana S.; Khavanin, Nima; Cray, James J.; Tuite, Gerald F.; Steinberg, Jordan P.; Rottgers, S. Alex.

In: Cleft Palate-Craniofacial Journal, Vol. 56, No. 8, 01.09.2019, p. 1001-1007.

Research output: Contribution to journalArticle

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