‘No Drain’ Strategy for Post-operative Orthopaedic Cases

BackgroundPost-operative wound management plays an important role in orthopaedic recovery.Closed-suction drains are commonly used to reduce wound collection, hematoma, seroma, and tension; however, their routine use remains debatable due to concerns about increased blood loss, transfusion requirements, discomfort, prolonged hospital stay, infection risk, cost, and additional drain-site scarring. AimTo evaluate the results of the 'No Drain' strategy in post-operative orthopaedic cases. Materials and methodsThis prospective observational study was conducted from September 2024 to April 2026 after ethical approval.A total of 114 patients undergoing clean orthopaedic surgeries were divided equally into Group A and Group B, with 57 patients in each group.Group A was managed without a drain, while Group B was managed with a closed negative suction drain.The study included arthroplasty, trauma, spine, and arthroscopy procedures.Outcomes assessed included post-operative hemoglobin drop, packed cell volume (PCV) transfusion requirement, hospital stay, complications, Visual Analogue Scale score (VAS), Stony Brook Scar Evaluation Scale score (SBSES), and drain-related cost. ResultsGroup A had significantly lower post-operative hemoglobin drop than Group B (1.40 ± 0.69 g/dL vs 1.91 ± 0.80 g/dL; p < 0.001) and lower PCV transfusion requirement (0.72 ± 0.80 vs 1.18 ± 1.04 units; p = 0.010).Hospital stay was shorter in Group A (3.00 ± 0.00 vs 4.49 ± 1.70 days; p < 0.001).Complications were fewer in Group A (3.5% vs 17.5%; p = 0.015).Group A also showed a better VAS score (2.42 ± 1.12 vs 4.12 ± 1.56; p < 0.001) and SBSES score (3.88 ± 0.89 vs 2.89 ± 0.94; p < 0.001). ConclusionThe 'No Drain' strategy is safe, effective, patient-friendly, and cost-saving in clean post-operative orthopaedic cases.Routine drains should be used selectively.