DOI: http://dx.doi.org/10.18203/2349-2902.isj20220631

Role of subcutaneous suction drain in reducing surgical site infection in emergency laparotomy

Arun K. Naik, Arya S. V., Ashok K. Sharma

Abstract


Background: Surgical site infection (SSI) is a major postoperative wound complications associated with open abdominal surgery and is related to increased morbidity, mortality and healthcare costs. A subcutaneous suction drain reduces the dead space in the subcutaneous tissue plane and thereby prevents accumulation of fluid and seroma formation. In this study we observed the role of subcutaneous drain in reducing SSI in emergency laparotomies.

Methods: Prospective randomized comparative study comprising of 108 patients on the basis of inclusion and exclusion criteria. 54 patients were called cases in whom subcutaneous suction drain was placed and 54 patients were called controls in whom no drain was placed. Antibiotic prophylaxis was given to all patients. Surgical site infection (SSI) was diagnosed and graded using Southampton wound grading system.

Results: 24% of cases and 46% of controls developed SSI, 9% of cases and 33% of controls developed wound dehiscence and mean duration of hospital stay was 6days in cases and 10days in controls. All above parameters were statistically significant with p<0.05.

Conclusions: Subcutaneous suction drain is effective in reducing surgical site infection (SSI), wound dehiscence and mean duration hospital stay in emergency laparotomies.


Keywords


Surgical site infection, Subcutaneous suction drain, Emergency laparotomy

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References


Alkaaki A, Al-Radi OO, Khoja A, Alnawawi A, Alnawawi A, Maghrabi A, et al. Surgical site infection following abdominal surgery: a prospective cohort study. Can J Surg. 2019;1:111-7.

NICE, “Clinical Guideline 74—prevention and treatment of surgical site infection,” NICE, October 2008, http://www.nice.org.uk/nicemedia/pdf/ CG74NICEguideline.pdf. Accessed on 20 July 2021.

Astagneau P, Rioux C, Golliot F, Brücker G.INCISO Network Study Group. Morbidity and mortality associated with surgical site infections: results from the 1997-1999 INCISO surveillance. J Hosp Infect. 2001;48(4):267-74.

Townsend C M, Beauchamp R D, Evers B M, Mattox K L. Surgical infections and antibiotic use: Sabiston textbook of Surgery: The biological basis of modern surgical practice. 21st ed. Amsterdam: Elsevier. 2021;224-5.

Diana M, Hubner 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.

Drains. Dead Space Management in Complications in Surgery. Mulholland MW, Doherty GM (ed). 2nd ed., Philadelphia, Pa., USA: Wolters Kluwer, Lipincott William & Wilkins Health. 2011;148.

Kagita R, Mulla SA, Pai BS, Desai M. Subcutaneous negative pressure versus simple closure of skin incision following an emergency laparotomy: a randomized control study. Int Surg J. 2019;6:1230-7.

Patel PR, Koyani HB. Role of subcutaneous drain in class III and class IV laparotomy wound. Int Surg J. 2019;6:1495-9.

Wani JN, Bhat JA. Role of Negative Suction Subcutaneous Drains in Contaminated Abdominal Surgeries. J Gastrointest Dig Syst. 2019;9(1):587.

Nasta AM, Deolekar SS, Bajaj JS. Role of subcutaneous drains in reducing the incidence of incisional surgical site infections post emergency abdominal surgery-a prospective study of 100 cases. Int J Health Sci Res. 2015;5(9):119-24.

Manzoor B, Heywood N, Sharma A. Review of Subcutaneous Wound Drainage in Reducing Surgical Site Infections after Laparotomy. Surg Res Pract. 2015;2015:715803.

Zhuang J, Zheng W, Yang S, Ye J. Modified subcutaneous suction drainage to prevent incisional surgical site infections after radical colorectal surgery. Transl Cancer Res. 2020;9(2):910-7.

Manoharan GV, Sivakumar T, Kumar MA. Evaluation of the use of Subcutaneous Drains to prevent Wound Complications in Abdominal surgeries. Int Surg J. 2018;5:1368-72.

Wani JN, Bhat JA. Role of Negative Suction Subcutaneous Drains in Contaminated Abdominal Surgeries. J Gastrointest Dig Syst. 2019;9(1):587.

Khan AQ, Mahesh Kodalkar. Role of Negative Suction Drain in Subcutaneous Plane in Reducing Laprotomy Wound Infection. International Journal of Science and Research. 2016;5(1):692-4.

Alsafrani TA, Alabbasi AA, Dabroom AA, Alhothali MM, Alresini KA, Aboalsamh GA, et al. The Effectiveness of Superficial Drain to Reduce Surgical Site Infection in Colorectal Surgery. Cureus. 2021;13(8):e17232.