Role of subcutaneous drains in obese patients undergoing elective cholecystectomy: A cohort study

Chowdri, Nisar Ahmad; Qadri, Syed Asrar Ahmed; Parray, Fazl Q.; Gagloo, Mushtaq A.

doi:10.1016/j.ijsu.2007.05.011

Cited by 34 publications

(25 citation statements)

References 6 publications

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“…Therefore, their use should be driven by a proven benefit. One systematic review [89] and several RCTs [90][91][92][93][94][95][96][97][98] on the use of subcutaneous drains in abdominal surgery were found. They cover a wide range of operative indications: liver surgery, colorectal surgery, cholecystectomy, gynaecological surgery, caesarean section, and gastric bypass surgery.…”

Section: Subcutaneous Drains In Laparotomy Incisionsmentioning

confidence: 99%

European Hernia Society guidelines on the closure of abdominal wall incisions

Muysoms

Antoniou

Bury

et al. 2015

Hernia

488

406

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Section: Subcutaneous Drains In Laparotomy Incisionsmentioning

confidence: 99%

European Hernia Society guidelines on the closure of abdominal wall incisions

Muysoms

Antoniou

Bury

et al. 2015

Hernia

488

406

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“…Allaire et al 15 conducted a prospective randomized study on 79 women undergoing cesarean delivery and found that the use of closed suction drainage in the subcutaneous space may reduce the incidence of wound seroma, infection and gaping. In a cohort study, Chowdri et al 16 reported reduction in seroma formation in obese patients undergoing elective cholecystectomy after using subcutaneous drain (8.8% in study group vs. 33.6% in control group). Gallup et al 17 in their prospective study on 197 patients concluded that use of subcutaneous drains plus prophylactic antibiotics may decrease wound related complication rate when operating on obese gynecologic patients (20% in study group vs. 31% in control group).…”

Section: Methodsmentioning

confidence: 99%

“…There are no studies on usage of subcutaneous closed suction drain in emergency laparotomies for perforative peritonitis in the literature. However, similar studies using subcutaneous closed suction drain have been done for colorectal surgeries, caesarean delivery and other elective abdominal surgeries 13,[15][16][17][18][19][20][21] . In a study conducted by Ahmet et.…”

Section: Methodsmentioning

confidence: 99%

Role of subcutaneous closed vacuum drain in preventing surgical site infection in emergency surgery for perforative peritonitis: A randomized control study

Kumar

Chatterjee

Gupta

et al. 2017

Bangladesh J Med Sci

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Abstract:Objective: The aim of our study was to evaluate whether insertion of a subcutaneous closed suction vacuum drain at incisional surgical site reduces the incidence of surgical site infection (SSI) in post operative cases of exploratory laparotomy for perforative peritonitis. Methods: An institutional based randomized control study was performed with two hundred patients each included in the study (with drain) and control (without drain) group. Both groups were statistically similar in terms of various variables and thus comparable. All continuous variables were reported as mean ± SD and compared across groups using unpaired t-test. All categorical variables were reports as n (%) compared across groups using Chi-square test for independence of attributes. Result: Use of a subcutaneous closed suction vacuum drain results in statistically significant reduction in wound infection (58% vs 16%; p < 0.001). The most common organism causing SSI was found to be Escherichia Coli accounting for 62.5% and 62.7% of cases in drain group and control group respectively, followed by Klebsiella (12.5% vs 24.14%). Conclusion: Use of a subcutaneous closed suction vacuum drain is effective in reducing SSI in contaminated surgery like that for perforative peritonitis and also leads to reduction in SSI related complications like wound disruption, patient discomfort, bad cosmesis, prolonged hospital stay, antibiotic use and increased cost.

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“…13 However, findings regarding the utility of subcutaneous drains in the prevention of incisional SSI remain controversial, and some studies have found that subcutaneous drains do not reduce the incidence of SSI. [14][15][16][17] Our previous study also showed the possibility that subcutaneous drains would be useful only for patients with a high risk for incisional SSI and those with thick subcutaneous fat tissue, but not for all patients undergoing colorectal surgery. 13 A possible reason is that subcutaneous drain appears to be unnecessary or rather harmful in patients without thick subcutaneous fat tissue, since the drain is a foreign substance for the human body.…”

Section: S Urgical Site Infection (Ssi) Including Wound Infection (Imentioning

confidence: 99%

Novel Method of Surgical Incision Management in Patients Undergoing Colorectal Surgery

Fujii

Morita

Sutoh

et al. 2016

International Surgery

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We previously demonstrated that subcutaneous drain is effective for preventing incisional surgical site infection (SSI) in patients with thick subcutaneous fat in colorectal surgery. We have recently attempted a novel closure technique in colorectal surgery for the prevention of incisional SSI. In the current study, we described this novel method for prevention of incisional SSI and share our assessment of efficiency of this incision management in patients undergoing colorectal surgery. The procedure ''wound dressing with temporary negative pressure'' using Opsite Post-Op Visible and an Atom Multipurpose Tube, is a simple and easy method. Immediately after incisions were closed, Opsite Post-Op Visible dressing was applied over the incision site with an Atom Multipurpose catheter, and negative pressure was applied through the catheter. We analyzed the cases of 203 patients who underwent colorectal resection. In 60 cases, we performed this negative pressure system for prevention of SSI. We reviewed the clinical features of these cases treated by this novel method and found that the incisional SSI rate in patients who underwent colorectal resection was significantly reduced following the use of the new method. There were no complications in any of the cases due to DNP. This dressing with negative pressure (DNP) may lead to wound drainage and a reduction of dead space in a subcutaneous wound area. These findings indicate that the use of DNP is safe, easy, and effective for preventing incisional SSI in patients undergoing colorectal surgery. Obesity has been identified as a risk factor for infections and wound complications after a wide variety of surgical procedures. 7,8 We previously demonstrated that the risk of incisional SSI increases with obesity, and that the most useful predictor of incisional SSI is the thickness of subcutaneous fat (TSF), as evaluated by preoperative computed tomography (CT). 12 We also demonstrated that subcutaneous drain is effective for preventing incisional SSI in patients with thick subcutaneous fat in colorectal surgery.13 Subcutaneous drains are effective for wound drainage and reduce dead space in a subcutaneous wound area, which is considered to lead to a reduced risk of incisional SSI. 13 However, findings regarding the utility of subcutaneous drains in the prevention of incisional SSI remain controversial, and some studies have found that subcutaneous drains do not reduce the incidence of SSI.14-17 Our previous study also showed the possibility that subcutaneous drains would be useful only for patients with a high risk for incisional SSI and those with thick subcutaneous fat tissue, but not for all patients undergoing colorectal surgery.13 A possible reason is that subcutaneous drain appears to be unnecessary or rather harmful in patients without thick subcutaneous fat tissue, since the drain is a foreign substance for the human body. Thus, we have recently attempted a novel closure technique in surgery for colorectal surgery for the prevention of incisional SSI. The procedure, w...

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Role of subcutaneous drains in obese patients undergoing elective cholecystectomy: A cohort study

Abstract: Prophylactic use of subcutaneous drains in obese patients undergoing cholecystectomy was found to reduce the seroma formation significantly.

Cited by 34 publications

References 6 publications

European Hernia Society guidelines on the closure of abdominal wall incisions

European Hernia Society guidelines on the closure of abdominal wall incisions

Role of subcutaneous closed vacuum drain in preventing surgical site infection in emergency surgery for perforative peritonitis: A randomized control study

Novel Method of Surgical Incision Management in Patients Undergoing Colorectal Surgery

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