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COVID pandemic
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A precautionary measure that is frequently used after a neck surgery is the usage of suction drains, which allow the evacuation or air and fluids accumulated at the site of the surgery using negative pressure. Theoretically this helps promote better healing of the wound. Usage of suction drains, however, requires keeping some patients hospitalized after surgery for drain surveillance while they could have otherwise been discharged to safely begin their convalescence at home. In other cases, patient hospitalisation can be prolonged by the usage of suction drains, because surgeons wait for the output of the drain to fall below a certain quantity before removing them. This of course results in additional costs to the health system. The quantity below which the drain output should fall before drain removal is however not something agreed upon in the medical literature and is generally based on a surgeon's personal experience or that of the institution in which they practice. It would be important to better define this value, since prolonged usage of suction drains is not risk-free. Indeed, they constitute, among other things, an access for bacteria to cause an infection to develop inside the neck, which compromises wound healing and may result in more pronounced scarring. This study aims to compare a frequently used output value (30 mL per 24 hours) with a more permissive one of 50 mL per 24 hours. The investigators will look more specifically at wound complications, length of hospitalisation and cost-effectiveness for the health system. This study will recruit patients undergoing neck surgery at the Centre Hospitalier de l'Université de Montréal to compare both of these suction drain output values.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group 1: 30cc/24h | Active Comparator | This group represents the currently used value of drain output used to determine the timing of drain removal |
|
| Group 2: 50cc/24h | Experimental | This group represents the experimental value of drain output used to determine the timing of drain removal |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Suction drain removal | Other | Removal of negative pressure suction drain left in place to drain the surgical space after a neck surgery |
|
| Measure | Description | Time Frame |
|---|---|---|
| Duration of drainage | The length of time during which the suction drain is left in place, from the time of the surgery to the time of drain removal | At the time of patient discharge from the ward, usually up to 1 week |
| Measure | Description | Time Frame |
|---|---|---|
| Seroma rate | The rate of seroma as wound complication, defined as an accumulation of serous fluid in the surgical space | Up to 6 weeks following surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Duration of admission | Length of patient's stay in hospital after surgery | At the time of patient discharge from the ward, usually up to 1 week |
| Wound infection | Surgical site infection following surgery |
Inclusion Criteria:
Exclusion Criteria:
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| ID | Term |
|---|---|
| D006258 | Head and Neck Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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| Up to 6 weeks following surgery |