Placement of Wound Drain After Anterior Circulation Aneurysm Clipping: A Single-Center Retrospective Study

OBJECTIVE: Wound drain used to be a routine procedure after craniotomy for aneurysm clipping, although this was not based on clinical evidence. The purpose of our study was to determine the necessity of wound drain placement after anterior circulation aneurysm surgery. METHODS: Retrospective analysis of patients with anterior circulation aneurysms treated by clipping in the Department of Neurosurgery, Wuhan University Zhongnan hospital from January 2019 to December 2019 was carried out. Demographic and clinical data, including age, sex, body mass index, disease history, results of the laboratory and imaging examinations, and surgical logs, were reviewed. RESULTS: A total of 236 patients (90 male and 146 female) were included in the analysis and were divided into a Drain group and a No Drain group according to whether postoperative wound drainage was applied. There was no statistical difference in the incidence of a postoperative extradural hematoma between patients in the 2 groups. However, the incidence of postoperative meningitis was higher in the Drain group than in the No Drain group (9.09% vs. 1.59%, P = 0.009), and the total length of stay and postoperative length of stay in the Drain group were also more extended than in the No Drain group (17.32 +/- 6.45 vs. 14.43 +/- 5.75, P = 0.005; 12.83 +/- 5.07 vs. 9.82 +/- 4.50, P = 0.007, respectively). CONCLUSIONS: Postoperative wound drain did not significantly reduce the incidence of an extradural hematoma after anterior circulation aneurysm surgery. On the contrary, it may be associated with an increased incidence of postoperative meningitis and length of stay. Given these findings, the postoperative drain should be maintained cautiously and meet more rigorous application criteria.