The effect of placing drains and no drains after caesarean section in obese patients on patients' post‐operative wound complications: A meta‐analysis

TL;DR

This study finds that using drains after C-sections in obese patients reduces the risk of hematoma but does not significantly affect wound infection or dehiscence rates.

Contribution

The study provides new evidence on the effectiveness of drains in reducing hematoma risk in obese patients post-C-section.

Findings

Drain use was associated with a lower risk of hematoma compared to non-drain use.

No significant difference was found in wound infection rates between drain and non-drain groups.

No significant difference was found in wound dehiscence rates between drain and non-drain groups.

Abstract

The purpose of this research is to investigate the influence of placement of drainage channels and non‐drainage channels in obese women on post‐caesarean delivery. Documents were retrieved from four databases, such as PubMed and Embase. This study was not limited in time, language, or geography. This trial was conducted using either a cohort or a randomized, controlled study to compare the efficacy of placement of drain in caesarean delivery channel in obese women with or without drain for post‐operative wound complications. The study excluded those who were restricted to those who were not overweight. The main results were the wound infection, the bleeding of the wound and the dehiscence. The risk of bias was evaluated by two authors with a risk‐of‐bias tool for nonrandomized intervention trials. The meta‐analyses only included those that were considered to have a low‐to‐medium risk of bias. The data were pooled with a random‐effects model to determine the relative risk and 95% confidence interval (CI). The quality of the evidence in the selection of results was evaluated. Of 329 related trials, eight were eligible for inclusion. There were 1868 cases of obesity who received C‐section. Among them, there were 451 cases of drain and 1417 cases of non‐drain. No statistical significance was found in the rate of post‐operation infection of the post‐operation between non‐drain or drain treatment of obesity patients (OR, 0.8; 95% CI: 0.48–1.33; p = 0.39). Compared with those with non‐drain, there was a reduction in the risk of haematoma after drain (OR, 0.34; 95% CI: 0.20–0.58; p < 0.0001). The results showed that there were no significant differences in the influence of drainage and non‐drainage on the post‐operative dehiscence of the patients with obesity (OR, 0.84; 95% CI: 0.15–4.70; p = 0.85). The results showed that there were no statistically different effects on the rate of post‐operation wound infection and dehiscence after operation, but the rate of haematoma during drain operation was lower.