Evaluation of Outcomes of Subcutaneous Negative Suction Drain in Emergency Laparotomy in Children with Peritonitis

Abstract

Background: Emergency laparotomy for peritonitis is associated with the highest rates of infective complication, especially surgical site infection (SSI) and it's linked to higher morbidity, mortality, and healthcare costs. Aim of the Study: The aim of this study was to evaluate the outcome of subcutaneous negative suction drain in emergency laparotomy in children with peritonitis. Methodology: This prospective interventional study was conducted in the Department of Pediatric Surgery, Dhaka Medical College Hospital, Dhaka from January, 2020 to December 2021 over a period of two years. A total of 64 patients who underwent emergency laparotomy with features of peritonitis were enrolled in this study as per selection criteria. They were divided into two groups equally. Subcutaneous negative suction drain was used in Group A patients, and in Group B patient’s standard of care was provided. Patients were followed up to 30thpostoperative day. Outcome was evaluated by superficial surgical site infection (s-SSI), wound dehiscence, secondary suturing and duration of hospital stay. Superficial surgical site infection(s-SSI) assessed by CDC criteria of surgical site infection on 3rd, 5th, 7th, 14th& 30thpostoperative day. Microsoft Excel was used for data analysis. Results: Mean age of the study populations in Group A was 8.41 ± 2.27 years and Group B was 8.95 ± 2.27 years. Male were predominant than female in both the two groups. s-SSI was observed significantly(p=0.016) lower in Group A (9.4%) than Group B (34.4%). Culture & sensitivity growth was observed significantly(p=0.020) lower in Group A (6.3%) than Group B (28.1%). Wound dehiscence was (9.4%) in Group A and (28.1%) in Group B. Secondary suturing was (3.1%) and (15.6%) in Group A and Group B respectively. Duration of hospital stay was found significantly (p=0.011) lesser in Group A than Group B (6.68 ± 2.14 vs 8.50 ± 3.29) days. Conclusion: Subcutaneous negative suction drain reduces the post-operative superficial ..