To drain or not drain: literature versus practice.

To evaluate the current use, of and opinion regarding the use of closed suction drains in orthopaedic practice, a literature review and two surveys have been conducted. Recent literature suggests that there is no difference in terms of wound healing, post-operative pyrexia, range of motion, seroma collection, days of hospitalization and infection rate in drained and undrained groups in routine orthopaedic procedures. In the first survey, a questionnaire was sent to all members of the British Orthopaedic Association, to establish the incidence of the use of drains, their placement and the usual duration of drainage. In the second survey, all the orthopaedic consultants of the Mid-Trent Region were interviewed to establish their reasons for using drains. Both surveys indicate that drains are used routinely by the majority of orthopaedic surgeons regardless of the published literature. We conclude that most orthopaedic surgeons in the United Kingdom do not practice 'evidence-based medicine' with regards to wound drainage.