Subcutaneous Redon drains do not reduce the incidence of surgical site infections after laparotomy. A randomized controlled trial on 200 patients

Baier, P.; Glück, Nadine C.; Baumgartner, Ulrich; Adam, Ulrich; Fischer, Andreas; Hopt, Ulrich T.

doi:10.1007/s00384-010-0884-y

Cited by 62 publications

(50 citation statements)

References 8 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

503

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

503

406

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“…13 Suggested mechanisms of preventive action of subcutaneous drains are removing fluids and components in these fluids, reducing dead space of a subcutaneous wound area and helping keep the incision edges together. However, some studies have found that subcutaneous drains do not reduce the incidence of SSI, 16,17 and we also showed that the incisional SSI rate in patients with thick subcutaneous fat tissue was significantly reduced only in high-risk cases. These findings imply the possibility that subcutaneous drains would be useful for high-risk patients, but not for all patients undergoing colorectal surgery.…”

Section: Discussionmentioning

confidence: 51%

“…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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“…2 There are some studies where it was found that subcutaneous drains don't reduce incidence of Incisional SSI. 8 But numerous studies have demonstrated efficacy of subcutaneous drain especially negative suction drain in improving wound healing by reducing bacterial load, providing moist and protected environment (by removing residual effusion and blood from the wound that could serve as a medium for growth of bacteria), reducing oedema around wound and increasing rate of granulation tissue formation and epithelisation. 9 In this study red rubber corrugated drain was selected because of its easy availability, convenience of use and inexpensiveness and less studied previously as compared to negative suction drains.…”

Section: Resultsmentioning

confidence: 99%