Can Infection After Anterior Cruciate Ligament Surgery be Prevented by Inserting a Hemovac Drain Into Graft Donor Site?

Abstract

Objectives: This study aims to investigate the effect of Hemovacdrainage placed in graft harvesting area on preventing deepsurgical site infection (SSI) and/or septic arthritis through drainingthe hematoma formed in the graft area in arthroscopic primaryanterior cruciate ligament (ACL) reconstruction surgery usinghamstring autograft.Patients and methods: This retrospective study was conductedbetween January 2008 and March 2019. A total of 819 patients(769 males, 50 females; mean age 33.7 years; range, 25 to 41 years)who underwent arthroscopic primary ACL reconstruction surgeryusing hamstring autograft were divided into two groups basedon whether a Hemovac drain was also placed at the hamstringgraft harvested area. Both groups were compared in terms of thepresence of deep SSI and/or development of septic arthritis.Results: In the non-drained group (group 1, n=401), 16 patients(3.9%) had septic arthritis, four (0.9%) had deep SSI, and two(0.49%) had both wound and joint infections. Septic arthritis wasidentified in only one patient (0.2%) in the drained group (group 2,n=418). In group 2, the mean amount of blood coming from the drainat the graft harvesting region was 36.85 mL (range, 20-50 mL).Conclusion: In arthroscopic primary ACL reconstruction surgeryusing hamstring tendon autograft, we concluded that the use of aHemovac drain could be effective in preventing deep SSI throughreducing the hematoma occurring in this region. However, futurestudies are needed to validate the effect of Hemovac drain onpreventing the septic arthritis.