Effectiveness of Subcutaneous Suction Drain vs. Simple Skin Closure in Reducing Postoperative Surgical Site Infections After Emergency Laparotomy

Abstract

Background: Surgical Site Infections (SSIs) are prevalent complications following surgeries, especially after major abdominal procedures like emergency laparotomies. In resource-limited settings such as Bangladesh, effective strategies to reduce SSIs are crucial for improving patient outcomes. Objective: This study aims to evaluate the effectiveness of subcutaneous suction drains versus simple skin closure in reducing postoperative SSIs in patients undergoing emergency laparotomy in Bangladesh. Method: A prospective, case-control study was conducted at the Department of Surgery, Jalalabad Ragib-Rabeya Medical College & Hospital, Sylhet, Bangladesh, from June 2023 to July 2024. A total of 100 patients undergoing midline exploratory laparotomy were randomly assigned to either the case group (subcutaneous suction drain) or the control group (simple skin closure). Data on demographics, co-morbidities, and surgical outcomes were collected. The primary outcome was the incidence of SSIs, with secondary outcomes including hospital stay duration and other complications. Statistical analysis was performed using SPSS version 22. Results: The SSI rate was significantly lower in the subcutaneous suction drain group (10%) compared to the simple skin closure group (42%). The average hospital stay was also significantly shorter for the subcutaneous suction drain group (8.84 days) versus the simple skin closure group (11.20 days). Co-morbidities such as hypertension and diabetes showed no significant difference between groups. Conclusion: The use of subcutaneous suction drains significantly reduces the incidence of SSIs and shortens hospital stays after emergency laparotomies. These findings support the implementation of subcutaneous suction drains as a beneficial practice in surgical management, particularly in resource-limited settings.