No difference between irrigating and non-irrigating drains in the management of severe odontogenic infection

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Dental infections all too frequently result in cellulitis or abscess formation. Treatment often requires incision and draining allow with extraction of the tooth. Simple non-irrigating gravity drains have been in use for more than a century while catheter type drains which allow the possibility of daily irrigation are increasingly popular.   The aim of this trial was to assess whether the use of irrigating drains in patients with severe odontogenic infection compared with non-irrigating drains result in a shorter length of stay (LOS).

Consecutive patients with severe odontogenic infections who required incision and drainage were randomized to irrigating drains (red rubber catheters n=24) or non-irrigating drains (Penrose drains, n= 22). The primary outcome was length of stay.

  • The mean LOS after surgery for the irrigating and non-irrigating groups was 2.8 and 3.3 days, respectively. The mean difference of 0.5 days (95% confidence interval, 0.6 to 1.6 days) was not significant (P = .38).
  • There was no statistically significant difference in overall length of stay, length of stay after surgery, temperature, or need for additional procedures between the 2 treatment groups.

The authors concluded

The use of non-irrigating drains appears to be equally efficacious as irrigating drains in the management of severe odontogenic infection.

Comment

This is is a relatively small study and, as the authors point out no power calculation was carried out so it may have been underpowered.

Links

Bouloux GF, Wallace J, Xue W. Irrigating Drains for Severe Odontogenic Infections Do Not Improve Outcome. J Oral Maxillofac Surg. 2012 Jun 20. [Epub ahead of print] PubMed PMID: 22726703.

 

 

 

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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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