A Study of Cases in Which Penrose Drains Were Selected for Postoperative Hemorrhaging After Head and Neck Surgery

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Abstract
Closed suction drains are commonly used after head and neck surgery, but airway obstruction due to postoperative hemorrhaging can be fatal. Some studies have suggested that cervical circumference should be assessed after thyroid surgery to detect such problems early. Rapid responses may be difficult at facilities with limited staffing. We opted for Penrose drains in cases in which the risk of postoperative hemorrhaging was expected to be high, and we examined the effectiveness of this approach in this study. Between October 2022 and December 2023, 25 of 68 (37%) head and neck operations involved the placement of a Penrose drain. Their medical records were reviewed retrospectively. There were 20 cases involving neck dissection, which was performed via a wide range of surgical techniques. Intraoperative findings (e.g., significant oozing of blood) was the most common reason for choosing the open technique (10 cases). The duration of drain placement was < 7 days (mean: 4.68 days). There were no surgical site infections; two cases of postoperative hemorrhaging; and no fatal problems, such as airway obstruction, but delayed wound healing due to wound-edge dehiscence was observed in some cases. There were no cases of airway narrowing due to postoperative hemorrhaging. Penrose drains are considered a good indication for cases with a history of radiotherapy causing postoperative haemorrhage, cases on oral anticoagulants, lesions in the deep parotid to parapharyngeal space that are difficult to recognise for haematoma formation, and cases where negative pressure should be avoided for exposure of anastomotic vessels and nerves, and should continue to be investigated.

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