A Comparative Study on Subcutaneous Negative Suction Drain vs. No Drain in Emergency Laparotomy Wounds for Peritonitis

TL;DR

This study found that using a subcutaneous negative suction drain after emergency abdominal surgery reduces infection and fluid buildup compared to no drain.

Contribution

The study introduces subcutaneous negative suction drainage as a novel method to reduce surgical site infections and complications after emergency laparotomy for peritonitis.

Findings

Subcutaneous negative suction drainage reduced surgical site infections and incision discharge.

Seroma formation occurred in 16.67% of patients without drains but none with drains.

No significant differences were found in wound dehiscence or hospital stay duration between groups.

Abstract

Aim

This study aimed to compare the effectiveness of subcutaneous negative suction drainage vs. no drainage in reducing postoperative complications following emergency laparotomy for peritonitis.

Objective

The primary objective of this study was to evaluate the effect of subcutaneous negative pressure closure on various postoperative outcomes in patients undergoing emergency surgery. Specifically, the study aims to assess its impact on the incidence of surgical site infection (SSI), wound dehiscence, the need for secondary suturing, and the duration of hospital stay. Additionally, the study seeks to determine whether the observed SSIs are primarily attributable to intra-abdominal infections or are a result of hospital-acquired cross infections.

Materials and methods

A prospective comparative study was conducted on 60 patients diagnosed with peritonitis who underwent emergency laparotomy. They were randomly assigned into two groups of 30 patients each: Group A (with subcutaneous negative suction drain) and Group B (without drain). In Group A, drain fluid was analyzed for infection characteristics, while wound discharge from both groups was assessed microbiologically, where present.

Results

Group A included 21 males (70%) and nine females (30%), while Group B had 26 males (86%) and four females (13%). Midline vertical incisions were used in 90% of cases, with the remaining 10% receiving right paramedian incisions. Discharge from the incision site was observed in five patients (16%) in Group A and 13 patients (43%) in Group B (p = 0.024). SSIs occurred in five patients (16.67%) in Group A and in eight patients (26%) in Group B. Seroma formation was observed in five patients (16.67%) in Group B, but none in Group A. No significant differences were noted in wound dehiscence, need for secondary suturing, or duration of hospital stay between the groups.

Conclusion

Subcutaneous negative suction drainage significantly reduced the incidence of SSI, seroma formation, and discharge from the incision site following emergency laparotomy for peritonitis. This may lower the risk of wound complications and postoperative morbidity. Further randomized controlled trials are recommended to validate these findings.