Are drains really required in thyroid surgery

Background: Traditional use of drain in thyroid surgeries was to avoid any possible hematoma. The aim of the present study was to prospectively determine whether the use of the drain in thyroid surgery really helps the patient or it just adds morbidity to patients' post operative recovery phase

Patients and Methods: 132 patients who underwent total thyroidectomy without drain placement for benign conditions of thyroid were evaluated for outcome in terms of in hospital stay, wound infection, hematoma formation and re-exploration owing to untoward bleed. The study was conducted for 42 months with one month followup period. Results were compared with the control group from hospital records during the same study period

Results: Hematoma developed in 4 [3%] patients, infection in 2 [1.5%], hypocalcemia in 28 [21%] and recurrent laryngeal nerve [RLN] palsy 01[.75%] patients. There was no re-exploration for hematoma nor any in hospital mortality. In hospital stay was 1.8 days on average

Conclusion: Use of drain in thyroid surgery has no added benefit in terms of patient outcome rather it may increase the cost of treatment, patient's morbidity and hospital stay

Outcome of primary repair in penentrating colonic injuries

To assess the outcome of primary repair in penetrating colonic injuries in terms of regional/local morbidity [suture line breakdown, intra-abdominal abscess] and mortality. Design: Prospective, interventional study. Place and Duration of Study: Surgical Unit II at Lahore General Hospital, Lahore, over a period of 3 1/2 years from June 1999 to December 2002. Patients and Out of 38 consecutive patients with penetrating colon injuries, a selective group of 25 patients [65.7%] undergoing primary repair [simple suture, resection and anastomosis without covering colostomy and right hemicolectomy] were included in this study. The morbidity and mortality variables were recorded and statistically analyzed. Majority of our patients were of younger age group [mean 25 years]. Twenty patients [80%] were male. The commonest mode of injury was firearm injury [72%]. The time interval between injury and repair was 3-11 hours [mean 7 hours]. Simple repair of colon with interrupted stitches was the commonest procedure performed [44%], followed by right hemicolectomy [32%]. Colon related complications developed in 3 patients [12%], which included two fecal fistulae and one intra-abdominal collection. One patient died of septicemia [4%]. Hospital stay ranged between 6-16 days [mean 8 days]. Primary repair is a safe method of managing penetrating colon injuries in carefully selected patients