Relevance of the systematic culture of the intraoperative swab and drain tip of Redon in Orthopaedic-Traumatology surgery

Are systematic drain tip or drainage fluid cultures predictive of surgical site infections?

“…Between studies, the SSI proportion varied from 0% (95% CI [0-11]) to 20% (95% CI ), and the pooled proportions were 2% (95% CI [1][2][3][4]) for drain tip culture studies and 5% (95% CI [1][2][3][4][5][6][7][8][9][10] for drainage fluid culture studies) (Figure 2).…”

“…When studying the concordance between the drain tip or drainage fluid cultures and the SSI isolated bacteria, PPVs were very low (6%, 95% CI [0-23] for drain tip cultures and 7%, 95% CI [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] for drainage fluid cultures) (Supplemental material 2).…”

“…Systematic drain tip or drainage fluid cultures seem to be of little value since the PPVs that represent the probability of SSI in the presence of a positive culture were low (11%, 95% CI for drain tip cultures and 12%, 95% CI for drainage fluid cultures). Moreover, the micro-organisms identified in the cultures did not systematically correspond to the microorganisms involved in SSI (PPVs of 6%, 95% CI [0-23] for drain tip cultures and 7%, 95% CI [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] for drainage fluid cultures). Sensitivities were also poor; thus systematic drain tip or 8 drainage fluid cultures are not reliable predictors of SSI in the absence of clinical signs.…”

“…We also contacted five authors of studies that were potentially eligible for inclusion in the meta-analysis in order to obtain additional information or new results [7][8][9][10][11]. Two of them replied to us [7][8].…”