The role of subcutaneous drain in laparotomy patients

Abstract

Background: In surgical incision wounds, hematoma, serous fluid, and dead space increase the risk of infection because they provide a surface for microbial growth. Subcutaneous drain reduces dead space in the subcutaneous tissue plane, which prevents fluid from accumulating and seroma from forming by removing infectious content, residual effusion, and blood from the wound. This study attempts to determine the efficacy of subcutaneous drain in laparotomy in the management of surgical site infection (SSI). Methods: This prospective study was conducted at the Department of Surgery in various hospitals in Cumilla, Bangladesh. This study includes 150 adult patients aged between 18 to 70 years. A closed subcutaneous suction drain was inserted before the skin was closed in 75 patients at random (drain group), whereas the rest of the 75 patients' subcutaneous suction drains were not kept (no-drain group). Results: The association between comorbidities and SSI in both the drain and no-drain groups were significant, p value <0.001 respectively. SSI was mainly in the group with fewer surgery hours (72.4%). Patients with SSI also have longer hospital stays on average. Conclusions: Patients with SSI have increased morbidity, and those undergoing major procedures are more likely to experience SSI afterwards. The presence of a subcutaneous closed suction drain contributes to reducing SSI.