To drain or not to drain after thyroid surgery: a randomized controlled trial at a tertiary Hospital in East Africa

Introduction: In many facilities, drains are routinely inserted after thyroidectomy with the aim of preventing hematoma formation and accumulation of seroma. The continued use of drains may be based more on tradition rather than proven scientific evidence.
Objective: To assess the benefit of drain use after thyroidectomy by determining; length of hospital stay, post operative pain and wound sepsis.
Methods: This was a randomized controlled trial, carried out at a tertiary national referral hospital (Mulago, Kampala). Over Over a 6 month period in 2011, we recruited 68 patients. Socio-demographic information and clinical parameters were recorded. Outcomes measures were evaluated. Data were double entered into epidata version 3.1.1 and analyzed using STATA version 10.0. Ethical approval was secured.
Results: Mean age of participants was 46 and 43.7 years in drain and no drain arm respectively. Most participants were female. Mean duration of hospital stay after thyroidectomy was significantly higher among the drain arm as compared with the no drain arm [2.41 (±0.89) vs 1.71 (±0.76) days (p= 0.0008)]. One patient (drain arm) had wound infection. The pain score on the postoperative day was statistically higher among in the drain arm than the no drain arm [5.71 vs 2.53 (p =0.001)].
Conclusion: Not inserting a drain post operatively after thyroid surgery was associated with short hospital stay and less operative pain. Results of this study do not support routine drainage after thyroid surgery.