Prophylactic Wound Drainage in Renal Transplant: A Survey of Practice Patterns in Australia and New Zealand.
Exp Clin Transplant
; 18(7): 771-777, 2020 12.
Article
en En
| MEDLINE
| ID: mdl-32967598
ABSTRACT
OBJECTIVES:
Drains are used routinely in many centers at the conclusion of kidney transplant, despite a paucity of evidence to guide practice in kidney transplant. Studies have not shown benefit from prophylactic drain placement following other major abdominal and vascular operations, and usage is consequently declining. Our aim was to understand practice patterns and rationale for behavior in drain placement and management in kidney transplant. MATERIALS ANDMETHODS:
We conducted an online survey of surgeons who routinely perform kidney transplants across Australia and New Zealand.RESULTS:
The response rate was 66% (43/66). Of respondents, 61% reported routine drain insertion, whereas 21% seldom inserted drains. Concerns about bleeding and anticoagulation (63%) and routine practice (58%) were the dominant reasons for drain insertion. The factors selected as most significant in determining drain removal were both volume and time (44%) and volume alone (33%). A volume of < 50 mL/day (51%) was the most commonly reported threshold for removal. The postoperative period of days 3 to 5 was the most commonly selected time point for drain removal (63%). Seventy-four percent of respondents would consider enrolling their patients in a randomized controlled trial to determine the benefits and harms of drain insertion.CONCLUSIONS:
Although drain insertion is a common practice, transplant surgeons in Australia and New Zealand reported sufficient uncertainty concerning the potential benefits and harms to warrant design and conduct of a randomized controlled trial.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
Problema de salud:
1_acesso_equitativo_servicos
/
1_desigualdade_iniquidade
Asunto principal:
Pautas de la Práctica en Medicina
/
Drenaje
/
Trasplante de Riñón
/
Disparidades en Atención de Salud
/
Cirujanos
Tipo de estudio:
Clinical_trials
/
Etiology_studies
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
/
Equity_inequality
Límite:
Humans
País/Región como asunto:
Oceania
Idioma:
En
Revista:
Exp Clin Transplant
Asunto de la revista:
TRANSPLANTE
Año:
2020
Tipo del documento:
Article
País de afiliación:
Australia