Drain versus no-drain at the donor sites of iliac crest bone graft: a retrospective study

Background: Closed suction drainage is typically used in orthopaedic surgery to reduce the occurrence of incision complications. However, whether drainage tubes should be routinely placed in iliac crest bone graft surgeries is still unclear. This study aimed to evaluate the effect of closed suction drainage at iliac crest bone donor site on clinical prognosis.

Materials and methods: G.Power was used for a prior analysis to estimate the required sample size. 91 patients with tibial plateau fractures who underwent iliac crest harvesting and grafting between January 2019 and January 2022 were enrolled in the study. All surgeries were performed by the same experienced surgeon team. Patients were divided into close suction drainage (CSD) group and no-CSD group according to the use of drainage tube. The demographic and perioperative data of the patients were collected and analyzed.

Results: There were no significant differences in demographic characteristics between the two groups except that the CSD group had more people with diabetes. The use of closed suction drainage in patients undergoing iliac crest harvest can significantly reduce the incidence of incision complications without increasing pain level and extending hospital stay. However, the closed suction drainage obviously caused the increase of blood loss. More drainage tubes would cause more drainage fluid to flow out. And drainage tube placement may impose a higher financial burden on patients.

Conclusion: The closed suction drainage should not be recommended routinely for iliac crest bone graft patients. Only when the patient is at high risk for infection and without severe blood loss, placing a single drainage tube is recommended.

Trial registration: This study was registered at (NCT04807062) and approved by the Ethics Committee of the participating institution (Theoretical No. 2015-003-1).