Safety of drainless excision of the submandibular gland

Abstract Introduction: Percutaneous drains can be associated with several complications, including infection, fistula formation, discomfort and prolonged hospitalization. Objective: The aim of this study was to evaluate the safety of submandibular gland excision without the use of surgical drains. Methods: We analyzed the surgery time, postoperative complications such as bleeding, facial palsy, seroma, and repeat exploration of wounds and duration of the hospital stay. Excision of the submandibular gland via a transcervical approach was undertaken by two surgeons. Prior to wound closure, the skin flap and wound bed were approximated using hemostatic fibrin glue (Greenplast-Q PFS KIT®, GC Greencross, Youngin, Korea). Neither saline irrigation nor insertion of a percutaneous drain were included. Results: A total of 23 patients underwent submandibular gland excision. The study group consisted of 14 men (60.8%) and 9 women (39.2%) (mean age, 47.6 years; range, 24-70 years). There were two patients who had minor complications. One patient showed minor bleeding on the skin incision line immediately postoperatively, and one developed a seroma at 7 days postoperatively. There were no major surgical complications. Total duration of the surgery from skin incision to closure averaged 44.86 minutes. Mean duration of the hospital stay was 3.17 days. Patients were discharged on average at 1.17 days after surgery. Conclusion: The submandibular gland can be safely excised without the use of a surgical drain, therefore allowing early patient discharge.

摘要 引言：经皮引流管（percutaneous drains）可伴随多种并发症，包括感染、瘘管形成、不适及住院时间延长。研究目的：本研究旨在评估不使用手术引流管的下颌下腺切除术（submandibular gland excision）的安全性。研究方法：本研究分析了手术时长、术后并发症（如出血、面神经麻痹（facial palsy）、血清肿（seroma）、伤口再次探查）以及住院时长。由两名外科医师经颈入路（transcervical approach）行下颌下腺切除术。在关闭伤口前，使用止血纤维蛋白胶（hemostatic fibrin glue，Greenplast-Q PFS KIT®，GC Greencross，韩国龙仁）对皮瓣及创面进行贴合。本研究未进行生理盐水冲洗，也未置入经皮引流管。研究结果：共计23例患者接受了下颌下腺切除术。研究队列包含男性14例（占比60.8%）、女性9例（占比39.2%），平均年龄47.6岁，年龄范围为24~70岁。其中2例患者出现轻微并发症：1例于术后即刻在皮肤切口处出现少量出血，1例于术后7天出现血清肿。未出现重大手术并发症。从皮肤切开至伤口闭合的总手术时长平均为44.86分钟。平均住院时长为3.17天，患者平均于术后1.17天出院。研究结论：不使用手术引流管的下颌下腺切除术安全性良好，可实现患者早期出院。