Routine subcutaneous drains versus no drains in repeated elective and emergent cesarean sections

Abstract

Objective The aim of this study was to determine whether the routine use of subcutaneous drains can reduce the wound complications following cesarean section (CS). Background CS is one of the most common operative procedures performed in modern obstetrics. One of the most common complications of CS is surgical site complications, including infection, seroma formation, and disruption. One of the common, yet debatable, practices in CS is the use of a subcutaneous drain for the wound. Patients and methods This is a randomized controlled study that was conducted at the obstetrics and gynecology department, Menoufia university hospitals. The study included 200 patients who were subjected to CS. They were divided into two groups: group 1, which included patients in whom a subcutaneous drain was used, and group 2, which included patients in whom no subcutaneous drain was used. The duration of surgery and the duration of hospital stay were recorded. The patients were followed up and the following complications were assessed: wound infection, wound seroma, wound disruption, postoperative pain, and postoperative fever. Results Use of subcutaneous drains significantly reduced wound seroma (21% in the no drain group and 3% in the drain group), wound disruption (38% in the no drain group and 9% in the drain group), the need for redressing (41% in the no drain group and 12% in the drain group), and postoperative pain (a mean ± SD of 5.4 ± 0.9 in the no drain group and 2.76 ± 1.17 in the drain group). There was no significant difference as regards wound infection or the duration of postoperative hospital stay. Conclusion We found that the routine use of subcutaneous drain for lean women undergoing CS can only reduce wound seroma, wound disruption, postoperative pain, and the need for redressing. However, there was no added benefit as regards other wound complications such as wound infection and postoperative fever.