Kamal Dhafer, Sivaramakrishnan Gowri, Ashour Amr, Ebrahim Basel M, Morsi Maged
Vascular and Endovascular Surgery, King Hamad University Hospital, Bahrain Defence Force Royal Medical Services, Al Sayh, BHR.
The Crown Prince Center for Training and Medical Research, Bahrain Defence Force Royal Medical Services, Riffa, BHR.
Cureus. 2025 May 12;17(5):e83941. doi: 10.7759/cureus.83941. eCollection 2025 May.
Surgical drains are commonly used in vascular surgery to control fluid buildup and reduce postoperative complications; however, their overall benefit remains uncertain due to inconsistent findings and the absence of standardized guidelines. This systematic review aimed to evaluate the role of surgical drains in vascular procedures such as carotid endarterectomy, aortic aneurysm repair, and peripheral arterial bypass, particularly in relation to complications, wound healing, length of hospital stay, and patient recovery. A comprehensive search was conducted across PubMed, Embase, Cochrane, and Google Scholar, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies included randomized controlled trials (RCTs), cohort, and case-control studies that reported on relevant clinical outcomes. Nine studies met the inclusion criteria. The findings revealed mixed results regarding the effectiveness of drains in reducing complications such as hematoma and bleeding, with some benefits noted in specific patient populations. However, an increased risk of surgical site infections was frequently observed with drain use. In certain procedures, such as abdominal aortic aneurysm repair, drains may help prevent the increase in postoperative intra-abdominal pressure, although their influence on overall recovery remains unclear. Given these variable outcomes, the routine use of surgical drains in vascular surgery cannot be universally recommended. Instead, their application should be tailored based on individual patient risk factors and the complexity of the surgical procedure. Additional high-quality studies are needed to develop clear, evidence-based guidelines for their use.
手术引流管在血管外科手术中常用于控制液体蓄积并减少术后并发症；然而，由于研究结果不一致且缺乏标准化指南，其总体益处仍不明确。本系统评价旨在评估手术引流管在颈动脉内膜切除术、主动脉瘤修复术和外周动脉搭桥术等血管手术中的作用，特别是与并发症、伤口愈合、住院时间和患者恢复相关的作用。按照系统评价和Meta分析的首选报告项目（PRISMA）指南，在PubMed、Embase、Cochrane和谷歌学术上进行了全面检索。纳入的研究包括报告相关临床结局的随机对照试验（RCT）、队列研究和病例对照研究。九项研究符合纳入标准。研究结果显示，关于引流管在减少血肿和出血等并发症方面的有效性存在混合结果，在特定患者群体中观察到了一些益处。然而，使用引流管时手术部位感染的风险经常增加。在某些手术中，如腹主动脉瘤修复术，引流管可能有助于防止术后腹内压升高，但其对总体恢复的影响仍不清楚。鉴于这些不同的结果，血管外科手术中不能普遍推荐常规使用手术引流管。相反，应根据个体患者的风险因素和手术的复杂性来调整其应用。需要更多高质量的研究来制定关于其使用的清晰、基于证据的指南。
