PDF herunterladen
CC BY 4.0 · Surg J (N Y) 2021; 07(04): e275-e280
DOI: 10.1055/s-0041-1735900
Original Article

Efficacy of Subcutaneous Closed Suction Drain in Reduction of Postoperative Surgical Site Infection

R. Harish
1   Department of General Surgery, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India
,
Farah Naaz Kazi
1   Department of General Surgery, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India
,
J.V. Pranav Sharma
1   Department of General Surgery, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India
› Institutsangaben
› Weitere Informationen
Auch verfügbar auf
   Lizenzen und Reprints

Abstract

Background Surgical site infections (SSIs) are the infections of wound after an invasive operative approach. It remains to be a major morbidity for patients undergoing surgeries although there have been tremendous improvements in the surgical techniques.

Different interventions to suppress the selective serotonin reuptake inhibitors have been proposed. Many of them have been routinely used by surgeons like minimizing shaving, hand washing, and preoperative antibiotics and these are well accepted. Drains are used in major abdominal surgeries, hernia repairs, breast surgeries reducing collections in closed areas.[1] Hematoma, serous fluid, and dead space in surgical incision wounds raise the risk of infection as they serve as the platform for microbial growth. Studies have proved that the usage of subcutaneous drains has lowered the chances of infection.

Results The patients in the case group had lower incidence of SSI compared with the control group. The patients in the case group had subcutaneous drain which drained any collection that developed in the subcutaneous space. When the incidence of SSI was compared between the emergency cases and elective cases, the emergency cases showed higher propensity for SSI and increased rate for patients who had co-morbidities like diabetes mellitus, hypertension, etc. The most common organism isolated from the SSI was found to be Escherichia coli. It was also noted that the mean number of days of hospital stay was comparatively higher for the patients who developed SSI compared with patients who did not develop SSI.

Conclusion Thus the presence of SSI adds morbidity to the patient and the patients who undergo major surgeries are likely to develop SSI postoperatively. The presence of subcutaneous closed suction drain helps in reducing the SSI to a certain extent.

Keywords

SSI - subcutaneous suction drain - exploratory laparotomy - microorganism - co-morbidity


Publikationsverlauf

Eingereicht: 04. Mai 2021

Angenommen: 22. Juli 2021

Artikel online veröffentlicht:
12. Oktober 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Arora A, Bharadwaj P, Chaturvedi H. et al. A review of prevention of surgical site infections in Indian hospitals based on global guidelines for the prevention of surgical site infection, 2016. J Patient Saf Infect Control 2018; 6: 1-12
    CrossrefPubMedSuche in Google Scholar
  • 2 NHSN. Surgical Site Infection Event. Accessed September 16, 2021 at: http://www.cdc.gov/nhsn/pdfs/pscmanual/9pscssicurrent.pdf
    PubMed
  • 3 National Nosocomial Infections Surveillance (NNIS). National Nosocomial Infections Surveillance (NNIS) System Report, Data Summary from January 1992-June 2001, issued August 2001. Am J Infect Control 2001; 29 (06) 404-421
    CrossrefPubMedSuche in Google Scholar
  • 4 Barie PS. Surgical site infections: epidemiology and prevention. Surg Infect (Larchmt) 2002; 3 (Suppl. 01) S9-S21
    CrossrefPubMedSuche in Google Scholar
  • 5 Shao J, Zhang H, Yin B, Li J, Zhu Y, Zhang Y. Risk factors for surgical site infection following operative treatment of ankle fractures: A systematic review and meta-analysis. Int J Surg 2018; 56: 124-132
    CrossrefPubMedSuche in Google Scholar
  • 6 Divino CM, Kuerer HM, Tartter PI. Drains prevent seromas following lumpectomy with axillary dissection. Breast J 2000; 6 (01) 31-33
    CrossrefPubMedSuche in Google Scholar
  • 7 Rosenberger LH, Politano AD, Sawyer RG. The surgical care improvement project and prevention of post-operative infection, including surgical site infection. Surg Infect (Larchmt) 2011; 12 (03) 163-168
    CrossrefPubMedSuche in Google Scholar
  • 8 Gilkar A, Dogra V. et al. Evaluation of subcutaneous negative pressure drain placement following emergency laparotomy. Int J Curr Res 2019; 11 (09) 7426-7429
    PubMedSuche in Google Scholar
  • 9 Gabriel A, Gupta S, Orgill DP. Challenges and management of surgical site occurrences. Plast Reconstr Surg 2019; 143 (1S): 7S-10S
    CrossrefPubMedSuche in Google Scholar
  • 10 Farnell MB, Worthington-Self S, Mucha Jr P, Ilstrup DM, McIlrath DC. Closure of abdominal incisions with subcutaneous catheters. A prospective randomized trial. Arch Surg 1986; 121 (06) 641-648
    CrossrefPubMedSuche in Google Scholar
  • 11 Dakhale GN, Hiware SK, Shinde AT, Mahatme MS. Basic biostatistics for post-graduate students. Indian J Pharmacol 2012; 44 (04) 435-442
    CrossrefPubMedSuche in Google Scholar
  • 12 Sunder Rao PSS, Richard J. An Introduction to Biostatistics, A Manual for Students in Health Sciences. 4 th ed.. New Delhi: Prentice Hall of India; 2006: 86-160
    Suche in Google Scholar
  • 13 Elenbaas RM, Elenbaas JK, Cuddy PG. Evaluating the medical literature. Part II: statistical analysis. Ann Emerg Med 1983; 12 (10) 610-620
    CrossrefPubMedSuche in Google Scholar
  • 14 Flynn JM, Rodriguez-del Rio F, Pizá PA. Closed ankle fractures in the diabetic patient. Foot Ankle Int 2000; 21 (04) 311-319
    CrossrefPubMedSuche in Google Scholar
  • 15 Jones KB, Maiers-Yelden KA, Marsh JL, Zimmerman MB, Estin M, Saltzman CL. Ankle fractures in patients with diabetes mellitus. J Bone Joint Surg Br 2005; 87 (04) 489-495
    CrossrefPubMedSuche in Google Scholar
  • 16 Ishikawa K, Kusumi T, Hosokawa M, Nishida Y, Sumikawa S, Furukawa H. Incisional surgical site infection after elective open surgery for colorectal cancer. Int J Surg Oncol 2014; 2014: 419712
    PubMedSuche in Google Scholar
  • 17 Fujii T, Tabe Y, Yajima R. et al. Effects of subcutaneous drain for the prevention of incisional SSI in high-risk patients undergoing colorectal surgery. Int J Colorectal Dis 2011; 26 (09) 1151-1155
    CrossrefPubMedSuche in Google Scholar
  • 18 Kashimura N, Kusachi S, Konishi T. et al. Impact of surgical site infection after colorectal surgery on hospital stay and medical expenditure in Japan. Surg Today 2012; 42 (07) 639-645
    CrossrefPubMedSuche in Google Scholar
  • 19 Gallup DC, Gallup DG, Nolan TE, Smith RP, Messing MF, Kline KL. Use of a subcutaneous closed drainage system and antibiotics in obese gynecologic patients. Am J Obstet Gynecol 1996; 175 (02) 358-361 , discussion 362
    CrossrefPubMedSuche in Google Scholar
  • 20 Tang R, Chen HH, Wang YL. et al. Risk factors for surgical site infection after elective resection of the colon and rectum: a single-center prospective study of 2,809 consecutive patients. Ann Surg 2001; 234 (02) 181-189
    CrossrefPubMedSuche in Google Scholar
  • 21 Smith RL, Bohl JK, McElearney ST. et al. Wound infection after elective colorectal resection. Ann Surg 2004; 239 (05) 599-605 , discussion 605–607
    CrossrefPubMedSuche in Google Scholar
  • 22 Cruse PJ, Foord R. A five-year prospective study of 23,649 surgical wounds. Arch Surg 1973; 107 (02) 206-210
    CrossrefPubMedSuche in Google Scholar
  • 23 Sugiura T, Uesaka K, Ohmagari N, Kanemoto H, Mizuno T. Risk factor of surgical site infection after pancreaticoduodenectomy. World J Surg 2012; 36 (12) 2888-2894
    CrossrefPubMedSuche in Google Scholar
  • 24 Okano K, Hirao T, Unno M. et al. Postoperative infectious complications after pancreatic resection. Br J Surg 2015; 102 (12) 1551-1560
    CrossrefPubMedSuche in Google Scholar
  • 25 Gavazzi F, Ridolfi C, Capretti G. et al. Role of preoperative biliary stents, bile contamination and antibiotic prophylaxis in surgical site infections after pancreaticoduodenectomy. BMC Gastroenterol 2016; 16: 43
    CrossrefPubMedSuche in Google Scholar
  • 26 Suragul W, Rungsakulkij N, Vassanasiri W. et al. Predictors of surgical site infection after pancreaticoduodenectomy. BMC Gastroenterol 2020; 20 (01) 201
    CrossrefPubMedSuche in Google Scholar
  • 27 Vilar-Compte D, Mohar A, Sandoval S, de la Rosa M, Gordillo P, Volkow P. Surgical site infections at the National Cancer Institute in Mexico: a case-control study. Am J Infect Control 2000; 28 (01) 14-20
    CrossrefPubMedSuche in Google Scholar
  • 28 Willett KM, Simmons CD, Bentley G. The effect of suction drains after total hip replacement. J Bone Joint Surg Br 1988; 70 (04) 607-610
    CrossrefPubMedSuche in Google Scholar
  • 29 Baier PK, Glück NC, Baumgartner U, Adam U, Fischer A, Hopt UT. Subcutaneous Redon drains do not reduce the incidence of surgical site infections after laparotomy. A randomized controlled trial on 200 patients. Int J Colorectal Dis 2010; 25 (05) 639-643
    CrossrefPubMedSuche in Google Scholar
  • 30 Pan HD, Wang L, Peng YF. et al. Subcutaneous vacuum drains reduce surgical site infection after primary closure of defunctioning ileostomy. Int J Colorectal Dis 2015; 30 (07) 977-982
    CrossrefPubMedSuche in Google Scholar