Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 6, 2020; 8(11): 2201-2209
Published online Jun 6, 2020. doi: 10.12998/wjcc.v8.i11.2201
Choice and management of negative pressure drainage in anterior cervical surgery
Qi-Hang Su, Kai Zhu, Yong-Chao Li, Tao Chen, Yan Zhang, Jun Tan, Song Guo
Qi-Hang Su, Kai Zhu, Yong-Chao Li, Yan Zhang, Jun Tan, Song Guo, Department of Orthopedics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China
Tao Chen, Department of Orthopedics, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai 200092, China
Author contributions: Su QH and Zhu K contributed equally to this work; Su QH, Zhu K, Guo S, and Tan J designed the research; Su QH, Zhu K, Zhang Y, Li YC, and Chen T performed the research; Chen T and Li YC contributed new analytic tools; Su QH and Zhu K analyzed the data; Su QH wrote the paper.
Supported by the Multicenter Clinical Trial of hUC-MSCs in the Treatment of Late Chronic Spinal Cord Injury, No. 2017YFA0105404; and the Key Discipline Construction Project of Pudong Health Bureau of Shanghai, No. PWZxk2017-08.
Institutional review board statement: Shanghai East Hospital (East Hospital Affiliated to Tongji University) Medical Ethics Committee approved the study protocol, which met the relevant guidelines and regulations of Shanghai Medical Ethics Committee.
Informed consent statement: All included volunteers had signed an informed consent form.
Conflict-of-interest statement: The authors declare that they have no financial or other conflicts of interest in relation to this research and its publication.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Song Guo, MD, Doctor, Department of Orthopedics, Shanghai East Hospital, Tongji University School of Medicine, No. 150, Jimo Road, Shanghai 200120, China. guosong941219@163.com
Received: January 5, 2020
Peer-review started: January 5, 2020
First decision: April 8, 2020
Revised: April 15, 2020
Accepted: April 27, 2020
Article in press: April 27, 2020
Published online: June 6, 2020
Processing time: 154 Days and 15.5 Hours
ARTICLE HIGHLIGHTS
Research background

Postoperative unobstructed drainage is an important measure for avoiding hematoma formation and preventing complications from anterior cervical surgery. Therefore, it is crucial to choose the safest and most reliable negative pressure drainage method correctly.

Research motivation

In clinical settings, the most common negative pressure drainage device in anterior cervical surgery is the silica gel negative pressure drainage ball. While routine, the incidence of airway complication is still very high.

Research objectives

Our team has attempted to use the gastrointestinal decompression apparatus to carry out negative pressure drainage in anterior cervical surgery. In this study, the authors aimed to discuss the characteristics and key points of clinical management of two types of commonly used negative pressure drainage systems in clinical settings.

Research methods

Two types of commonly used silica gel negative pressure drainage balls and a type of gastrointestinal decompression apparatus were fully emptied and then injected with different amounts of water and air. Following this, the negative pressure values of the three devices were measured. Meanwhile, we undertook a retrospective analysis of the clinical data of 1328 patients who had been treated with different negative pressure drainage apparatuses during their anterior cervical surgery.

Research results

As the amount of injected air or water increased, the negative pressure of the silica gel negative pressure drainage ball decreased rapidly, dropping to zero when 150 mL of water or air was injected. In contrast, the negative pressure of gastrointestinal decompression apparatus decreased slowly, maintaining an ideal value even when 300 mL of water or air was injected. And statistical analysis demonstrated that patients who had been treated with the gastrointestinal decompression apparatus were less likely to develop severe complications than those who had been treated with the silica gel negative pressure drainage ball (P < 0.05).

Research conclusions

This study showed that the gastrointestinal decompression apparatus has the advantages of large suction capacity, long duration of continuous negative pressure, and good drainage effect, all of which are the favorable factors for the use of this apparatus for negative pressure drainage in anterior cervical surgery.

Research perspectives

Multi-center prospective controlled trials with multi-factor analyses and assessments, larger sample size, and prolonged follow-up period are needed for future investigations.