The routine insertion of drains after total thyroidectomy by harmonic scalpel, is it always necessary?

Background and objective: Routine use of drains after thyroidectomy is not evidence based; nevertheless most surgeons use drains to alert them to the presence of postoperative bleeding and for the prevention of hematoma and seroma. This comparative study was conducted to evaluate the necessity of routine drainage after total thyroidectomy. Methods: A total of 150 patients who underwent total thyroidectomy due to different indications at different hospitals in Erbil city, Iraq from June 2011 to December 2015, were included. A retrospective comparison was made between those drained (group 1) and those without drain (group 2). Operating time, postoperative complications and hospital stay were assessed. Results: Operation time was significantly less in group 2 compared to group 1; 64.9 ± 7.64 minutes versus 73.8 ± 9.81 minutes, respectively. There was no statistically significant difference in the incidence of postoperative complications. Only two patients, both from group 1, developed a postoperative hematoma. Wound infection occurred only in 2 patients in group 1. Hospital stay was significantly shorter in group 2 compared to group 1; 21.1 ± 3.98 hours versus 41.7 ± 8.64 hours, respectively. Conclusion: The routine use of drain is not necessary after total thyroidectomy; it increases the hospital stay and may increase the rate of postoperative sepsis.