Retrospektive 4-Jahres-Analyse geschlossener Drainagesysteme an einem dermatochirurgischen Zentrum – Notwendigkeit einer individualisierten Anwendung

Zusammenfassung

Hintergrund Aktuell sind die Indikationen zum Einsatz von Wund-Drainagen und die dabei eingesetzten Systeme in der Dermatochirurgie nicht klar definiert. Es existieren bislang keine publizierten Daten über die Verwendung von Drainagesystemen in der Dermatochirurgie.

Fragestellung Ziel der vorliegenden retrospektiven Studie war die Deskription des Patientenkollektivs, welches mit Wunddrainagen versorgt wurde, die Ableitung von Indikationen und assoziierten Komplikationen im Zusammenhang mit Wunddrainagen.

Methode Es wurden 495 Patienten in die Studie eingeschlossen, welche im Rahmen eines dermatochirurgischen Eingriffs im Zeitraum zwischen 2010 und 2014 mit Hoch- oder Niedervakuum-Drainage-Systemen therapiert wurden.

Ergebnisse Am häufigsten wurden Eingriffe am Lymphgefäßsystem beobachtet (n = 321; 64,8 %), v. a. Sentinel-Lymphknotenbiopsien wurden mit einer Drainage versorgt. Insgesamt kam es in 11,5 % der 495 Fälle (n = 57) zu postoperativen Komplikationen. Patienten mit Drainage-Versorgung unterschieden sich signifikant im Body Mass Index (p = 0,022), in operativer Defektgröße (p < 0,001) und Operationszeit (p < 0,001) von solchen ohne. Die Komplikationsraten bei Operationen mit Drainage unterschieden sich nicht signifikant (p = 0,118) von Operationen ohne Drainagen.

Schlussfolgerungen Mit dieser retrospektiven Analyse beschreiben wir die dermatochirurgischen Situationen, in denen Wunddrainagen verwendet wurden und vergleichen diese sowie assoziierte Komplikationen zwischen Eingriffen mit und ohne Wunddrainage. Wir favorisieren eine individualisierte Indikationsstellung unter Berücksichtigung patientenseitiger Faktoren anstelle fixer Regularien.

Abstract

Background Currently, indications for the use of wound drains and draining systems used in dermatosurgery are not clearly defined. There are no published data on the use of drainage systems in dermatosurgery.

Purpose Aim of the present retrospective study was the description of the patient collective, which was treated with wound drainage, the derivation of indications and associated complications.

Method 495 patients were enrolled in the study that underwent dermatosurgical intervention between 2010 and 2014 using either high- or low-vacuum drainage systems.

Results Most frequently, interventions on the lymphatic system (sentinel lymph node biopsy) were observed (n = 321, 64.8 %). Overall, 11.5 % of the 495 cases (n = 57) had postoperative complications. Patients with drainage care differed significantly in body mass index (p = 0.022), operative defect size (p < 0.001), and surgical time (p < 0.001) of those without. The complication rates in drainage surgery did not differ significantly (p = 0.118) from surgery without drainage.

Conclusions In this retrospective analysis we describe the dermatosurgical situations in which wound drainages were used and compare these and associated complications between interventions with and without wound drainage. We favor an individualized indication with consideration of patient-side factors instead of fixed rules.

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