The association of surgical drains with surgical site infections – A prospective observational study

Abstract

BackgroundSurgical drains are widely used despite limited evidence in their favor. This study describes the associations between drains and surgical site infections (SSI). MethodsThis prospective observational double center study was performed in Switzerland between February 2013 and August 2015. ResultsThe odds of SSI in the presence of drains were increased in general (OR 2.41, 95%CI 1.32–4.30, p = 0.004), but less in vascular and not in orthopedic trauma surgery. In addition to the surgical division, the association between drains and SSI depended significantly on the duration of surgery (p = 0.01) and wound class (p = 0.034). Furthermore, the duration of drainage (OR 1.24, 95%CI 1.15–1.35, p < 0.001), the number (OR 1.74, 95%CI 1.09–2.74, p = 0.019) and type of drains (open versus closed: OR 3.68, 95%CI 1.88, 6.89, p < 0.001) as well as their location (overall p = 0.002) were significantly associated with SSI. ConclusionsThe general use of drains is discouraged. However, drains may be beneficial in specific surgical procedures.