The efficacy of active drainage for preventing postoperative organ/space surgical site infections in patients with Crohn’s disease

Abstract

Patients with Crohn's disease (CD) show a higher incidence of surgical site infections (SSIs) after bowel resection in comparison to other patient populations because CD patients commonly suffer from anemia, malnutrition, and immunosuppression. In comparison to conventional passive drainage, active drainage using a closed-suction drain reportedly reduces postoperative wound-related complications in several diseases. In the present study, we aimed to investigate the incidence of SSI and to identify the risk factors for SSI in patients with CD. We retrospectively analyzed the patient characteristics and perioperative data of 106 CD patients who underwent bowel resection at our institution between January 2000 and June 2016. We statistically analyzed the incidence of different types of SSI (overall, incisional, and organ/space) in relation to patient-related and surgery-related risk factors. Overall postoperative SSIs were diagnosed in 19 patients (17.9%), including incisional SSI (n=16; 15.1%), organ/space SSI (n=7; 6.6%), and both (n=4; 3.8%). A long operative time (p=0.036) and colonic involvement (p=0.011) were significantly associated with the overall risk of developing an SSI. Active drainage significantly reduced the incidence of organ/space SSI (p=0.037). Intraabdominal active drainage was more useful than passive drainage for preventing organ/space SSI development.