Is suction drainage an effective means of preventing hematoma in thyroid surgery? A meta-analysis

Objective: To evaluate the efficacy of suction drainage in preventing postoperative hematoma formation in thyroid surgery. Methods: We conducted a meta-analysis using only randomized controlled trials in which the incidence of post-thyroidectomy hematoma was compared directly in patients with and without suction drains (eight studies since 1980; N = 944). The odds ratio (OR) with respective confidence intervals (CIs) using the fixed effects model was reported. We used an OR < 1.0 as being in favour of treatment (ie, the use of suction drains). Results: In our meta-analysis, there was no statistically significant difference between the rates of post-thyroidectomy hematoma whether or not suction drains were used when the results were combined using a fixed effects model (OR 1.04, 95% CI-1.93), with p = .90. In this comparison, a fixed effects model was used rather than a random effects model because there was no statistically significant heterogeneity (chi(2) = 6.26, p = .28). Conclusions: We conclude that the use of suction drains in thyroid surgery to prevent postoperative hematoma is not evidence based.