Utility of Closed Suction Drains in Groin Incisions after Femoral Artery Exposure

Abstract

Surgical groin wounds are at risk of delayed healing and infection, leading to costly and prolonged postoperative recoveries. This study assesses the use of closed-suction drains (CSD) as a wound care adjunct in groin incisions to prevent surgical site infections (SSI). A single-center retrospective review was performed on 210 consecutive patients after vascular surgery with common femoral artery exposure from 2016 to 2021. The cohort was divided into two groups, groins with and without CSD, looking for surgical site complications. A subgroup analysis comparing postoperative outcomes between complicated and uncomplicated groin incisions within both groups was also performed. Of 293 surgical groins, 20% (n=59) had drains. Overall, the CSD group had higher SSI rates (14% Vs. 5.6%), but also had higher proportion of smokers (92% vs. 83%; p=0.019), diabetes (56% vs. 36%; p=0.005), coronary artery disease (69% vs. 46%; p=0.001), hyperlipidemia (69% vs. 51%; p=0.01) and previous groin surgery (54% vs. 17%; p<0.001). The higher risk of SSI was not significant after adjustment of these confounders. A separate analysis within each group showed SSI groins with CSD had lower reintervention rates (37.5%) than those without CSD (69%), as well as shorter length of hospital stay (7 [5-11] vs. 22 [7-25] days). Our study suggests that CSDs can be a beneficial adjunct for groin wounds after common femoral artery exposure in patients with comorbidities cited above. CSDs decrease the risk of reintervention and length of hospital stay.