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Postoperative outco...
Postoperative outcomes of pedicle screw instrumentation for adolescent idiopathic scoliosis with and without a subfascial wound drain: a multicentre randomized controlled trial
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- Helenius, Linda (författare)
- Department of Anaesthesia and Intensive Care, University of Turku and Turku University Hospital, Turku, Finland;Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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- Gerdhem, Paul (författare)
- Uppsala universitet,Ortopedi,Department of Clinical Science, Intervention, and Technology, Karolinska Institute and Department of Reconstructive Orthopaedics, Karolinska University Hospital, Stockholm, Sweden;Department of Orthopaedics, Uppsala University Hospital and Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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- Ahonen, Matti (författare)
- Department of Paediatric Surgery and Orthopaedics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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- Syvänen, Johanna (författare)
- Department of Paediatric Orthopaedic Surgery, University of Turku and Turku University Hospital, Turku, Finland
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- Jalkanen, Jenni (författare)
- Department of Paediatric Surgery, Kuopio University Hospital, Kuopio, Finland
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- Charalampidis, Anastasios (författare)
- Department of Clinical Science, Intervention, and Technology, Karolinska Institute and Department of Reconstructive Orthopaedics, Karolinska University Hospital, Stockholm, Sweden
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- Nietosvaara, Yrjänä (författare)
- Department of Paediatric Surgery, Kuopio University Hospital, Kuopio, Finland
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- Helenius, Ilkka (författare)
- Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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(creator_code:org_t)
- British Editorial Society of Bone & Joint Surgery, 2022
- 2022
- Engelska.
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Ingår i: The Bone & Joint Journal. - : British Editorial Society of Bone & Joint Surgery. - 2049-4394 .- 2049-4408. ; 104-B:9, s. 1067-1072
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- AimsThe aim of this study was to evaluate whether, after correction of an adolescent idiopathic scoliosis (AIS), leaving out the subfascial drain gives results that are no worse than using a drain in terms of total blood loss, drop in haemoglobin level, and opioid consumption.MethodsAdolescents (aged between 10 and 21 years) with an idiopathic scoliosis (major curve ≥ 45°) were eligible for inclusion in this randomized controlled noninferiority trial (n = 125). A total of 90 adolescents who had undergone segmental pedicle screw instrumentation were randomized into no-drain or drain groups at the time of wound closure using the sealed envelope technique (1:1). The primary outcome was a drop in the haemoglobin level during first three postoperative days. Secondary outcomes were 48-hour postoperative oxycodone consumption and surgical complications.ResultsAll 90 patients were included in the primary outcome analysis (no drain = 43; drain = 47). The mean total postoperative blood loss (intraoperative and drain output) was significantly higher in the group with a subfascial drain than in the no-drain group (1,008 ml (SD 520) vs 631 ml (SD 518); p < 0.001). The drop in haemoglobin level did not differ between the study groups over the postoperative timepoints (p = 0.290). The 48-hour opioid consumption was significantly higher in the no-drain group (2.0 mg/kg (SD 0.9) vs 1.4 (SD 0.6); p = 0.005). Two patients in the no-drain and one patient in the drain group developed a surgical site infection.ConclusionLeaving the subfascial drain out after pedicle screw instrumentation for AIS is not associated with higher postoperative haemoglobin levels. Patients treated without a subfascial drain needed 30% more opioids during the first 48 hours than those who had a drain.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Ortopedi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Orthopaedics (hsv//eng)
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