Role of subcutaneous suction drain in reducing surgical site infections after emergency laparotomy

Authors

  • Poonam Gupta Department of General Surgery, UPUMS, Saifai, Etawah, Uttar Pradesh, India
  • Rajesh Kumar Department of General Surgery, UPUMS, Saifai, Etawah, Uttar Pradesh, India http://orcid.org/0000-0002-6162-0161

DOI:

https://doi.org/10.18203/2349-2902.isj20173141

Keywords:

Emergency laparotomies, Subcutaneous drain, Surgical site infection

Abstract

Background: One of important morbidity postoperatively is surgical site infection and the important cause is collection of blood and serous fluids which can get infected and this factor is even more important in emergency laparotomies. our prospective randomised study compares the incidence of surgical site infection in post emergency abdominal surgical wounds with subcutaneous suction drains versus those in whom drain was not placed.

Methods: A prospective interventional study of 100 subjects done in department of surgery at rural tertiary centre. on the basis of exclusion and inclusion criteria patient were randomly selected for cases (with post-operative suction drain) and controls. subcutaneous drain in emergency setting play significant role in reducing the incidence of surgical site infection which is significant statistically.

Results: 24% of patients in drain group develop surgical site infections. 50% of patients in non-drain group develop infection. Incidence of infection in drain group was lower than the no drain group (p value 0.05) and was statistically significant.

Conclusions: Subcutaneous drain in emergency laparotomy play significant role in reducing the incidence of surgical site infection

Metrics

Metrics Loading ...

Author Biography

Rajesh Kumar, Department of General Surgery, UPUMS, Saifai, Etawah, Uttar Pradesh, India

ASSISTANT PROFESSOR

DEPARTMENT OF GENERAL SURGERY

 

References

Awad SS, Palacio CH, Subramanian A, Byers PA, Abraham P, Lewis D, et al. Implementation of a methicillin-resistant Staphylococcus aureus (MRSA) prevention bundle results in decreased MRSA surgical site infections. Am J Surg, 2009;198:607-10.

Kirby JP, Mazuski JE. Prevention of surgical site infection Surg Clin N. 2009;89:365-89.

Edwards PS, Lipp A, Holmes A. Preoperative skin antiseptics for preventing surgical wound infections after clean surgery. Cochrane database. Syst Rev. 2004:CD003949.

Homer-Vanniasinkam S. Surgical site and vascular infections: treatment and prophylaxis. Int J Infect Dis. 2007;11(1):17-22.

Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guidelines for prevention of surgical site infection. Infect Control Hosp Epidemiol. 1999;20:250-78.

Baier PK, Glück NC, Baumgartner U, Adam U, Fischer A, Hopt UT. Subcutaneous Redon drains do not reduce the incidence of surgical site infections after laparotomy. A randomized controlled trial on 200 patients. Int J Colorectal Dis. 2010;25:639-43.

Hellums EK, Lin MG, Ramsey PS. Prophylactic subcutaneous drainage for prevention of wound complications after cesarean delivery-a metaanalysis. Am J Obstet Gynecol. 2007;197:229-35.

Numata M, Tanabe H, Numata K, Suzuki Y, Tani K, Shiraishi R, et al. The efficacy of subcutaneous penrose drains for the prevention of superficial surgical site infections. Jpn J Gastroenterol Surg. 2010;43:221-8.

Watanabe A, Kohnoe S, Shimabukuro R, Yamanaka T, Iso Y, Baba H, et al. Risk factors associated with surgical site infection in upper and lower gastrointestinal surgery. Surgery Today. 2008;38(5):404-12.

Sharma A, Deeb AP, Iannuzzi JC, Rickles AS, Monson JRT, Fleming FJ. Tobacco smoking and postoperative outcomes after colorectal surgery. Ann Surg. 2013;258(2):296-300.

Sørensen LT. Wound healing and infection in surgery. The clinical impact of smoking and smoking cessation: a systematic review and meta-analysis. Arch Surg. 2012;147(4):373-83.

Kwaan MR, Sirany AME, Rothenberger DA, Madoff D. Abdominal wall thickness: is it associated with superficial and deep incisional surgical site infection after colorectal surgery? Surg Infect. 2013;14(4):363-8.

van Walraven C, Musselman R. The surgical site infection risk score (SSIRS): a model to predict the risk of surgical site infections. PLoS ONE. 2013;8(6):Article ID e67167.

Soper DE, Bump RC, Hurt WG. Wound infection after abdominal hysterectomy: effect of the depth of subcutaneous tissue. Am J Obstet Gynecol. 1995;173(2):465-71.

Fujii T, Tsutsumi S, Matsumoto A. Thickness of subcutaneous fat as a strong risk factor for wound infections in elective colorectal surgery: impact of prediction using preoperative CT. Digest Surg. 2010;27(4):331-5.

Cheadle WG. Risk factors for surgical site infection. Surg Infect, 2006;7: S7-11.

Diana M, Hübner M, Eisenring MC, Zanetti G, Troillet N, Demartines N. Measures to prevent surgical site infections: what surgeons (should) do. World J Surg. 2011;35(2):280-8.

Kosins AM, Scholz T, Cetinkaya M, Evans GRD. Evidence-based value of subcutaneous surgical wound drainage: the largest systematic review and meta-analysis. Plastic Reconst Surg. 2013;132(2):443-50.

Bohnen JMA. Use of drains in Abdominal Wall Hernias: Principles and Management, R. Bendavid, Ed, Springer, New York, NY, USA; 2001:328.

He XD, Guo ZH, Tian JH, Yang KH, Xie XD. Whether drainage should be used after surgery for breast cancer? A systematic review of randomized controlled trials. Med Oncol. 2011;28:S22-30.

Chelmow D, Rodriguez EJ, Sabatini MM. Suture closure of subcutaneous fat and wound disruption after cesarean delivery: a meta-analysis. Obstetrics Gynecol. 2004;103(5):974-80.

Saunders DI, Murray D, Pichel AC, Varley S, Peden CJ. Variations in mortality after emergency laparotomy: the first report of the UK emergency laparotomy network. Br J Anaesth. 2012;109(3):368-75.

Imada S, Noura S, Ohue M. Efficacy of subcutaneous penrose drains for surgical site infections in colorectal surgery. World J Gastro Surg. 2013;5(4):110-4.

Downloads

Published

2017-07-24

How to Cite

Gupta, P., & Kumar, R. (2017). Role of subcutaneous suction drain in reducing surgical site infections after emergency laparotomy. International Surgery Journal, 4(8), 2717–2720. https://doi.org/10.18203/2349-2902.isj20173141

Issue

Section

Original Research Articles