‘To Drain or Not’ in Abdominal Surgery

Abstract

The use of drains in abdominal surgeries is a matter of debate, especially the prophylactic use of a drain. In present times, the prophylactic use of drain is reducing due to some studies not supporting it. We are, in this study, discussing the pros and cons of using drains in abdominal operations. We are stressing through this study that drain helps in prevention and early detection of complications like bleeding, collection (pus, blood, bile, infected fluids) and anastomotic leaks. It also helps in early detection of the kind of fluid, which would be otherwise difficult even by radiological investigations, if drain has not been placed. Total of 50 cases of various abdominal surgeries, open and laparoscopic, are included in this study where drains were used. Informed written consent was taken. None of the patients had residual collections. Drains helped in prevention of post operative fluid collection. We advise placing a drain routinely, in cases of acute or chronic inflammation, or in cases with extensive dissection, in cases with risk of post op collection is high, cases with pus present in cavity, perforation peritonitis, trauma. Drains can always be removed early if they have a low output. But not placing a drain when it should have been placed, can result in preventable complications and add to the morbidity of the patient, sometimes significant.