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A randomized controlled trial of subcutaneous closed-suction Blake drains for the prevention of incisional surgical site infection after colorectal surgery

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background

The effects of subcutaneous closed-suction Blake drain for preventing incisional surgical site infections (SSIs) after colorectal surgery have never been evaluated in a randomized controlled trial (RCT). Thus, we performed a RCT to evaluate the clinical benefits of using a subcutaneous closed-suction Blake drain in patients undergoing colorectal surgery.

Method

Consecutive patients who underwent colorectal surgery were enrolled in this study. Patients were randomly assigned to the subcutaneous closed-suction drainage arm or the control (no subcutaneous drainage) arm. The primary endpoint was incidence rate of incisional SSIs. And, we performed logistic regression analysis to detect predictive factors for incisional SSIs after colorectal surgery.

Results

From November 2012 to September 2014, a total of 240 patients were enrolled in this study. One-hundred-seventeen patients who were treated by the control arm and 112 patients by the subcutaneous drainage arm were judged to be eligible for analysis. The incidence of incisional SSIs rate was 8.7 % in the overall patients. The incidence of incisional SSIs rate was 12.8 % in the control arm and 4.5 % in the subcutaneous drainage arm. There was significantly reduction of the incidence in the subcutaneous drainage arm than in the control arm (p = 0.025). Logistic regression analysis demonstrated that thickness of subcutaneous fat >3.0 cm, forced expiratory volume in 1 s as percent of forced vital capacity (FEV1.0 %) >70 %, and subcutaneous drain were independent predictors of postoperative incisional SSIs (p = 0.008, p = 0.004, and p = 0.017, respectively).

Conclusion

The results of our RCT suggest that a subcutaneous Blake drain is beneficial for preventing incisional SSIs in patients undergoing colorectal surgery.

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Authors and Affiliations

  1. Department of Surgery, Yokosuka Kyosai Hospital, 1-16 Yonegahama street, Yokosuka, 238-8558, Japan

    Jun Watanabe, Makoto Kawamoto, Yago Akikazu, Yusuke Suwa, Hidenobu Masui & Kaoru Nagahori

  2. Department of Surgery, Gastroenterological Center, Yokohama City University, Yokohama, Japan

    Mitsuyoshi Ota & Hirokazu Suwa

  3. Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, 236-0004, Japan

    Masashi Momiyama, Atsushi Ishibe & Kazuteru Watanabe

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  1. Jun Watanabe
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Correspondence to Jun Watanabe.

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Conflict of interest

Jun Watanabe, Mitsuyoshi Ota, Yusuke Suwa, Atsushi Ishibe, Kazuteru Watanabe, Hidenobu Masui, Kaoru Nagahori, and Itaru Endo have no conflicts of interest or financial ties to disclose.

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Watanabe, J., Ota, M., Kawamoto, M. et al. A randomized controlled trial of subcutaneous closed-suction Blake drains for the prevention of incisional surgical site infection after colorectal surgery. Int J Colorectal Dis 32, 391–398 (2017). https://doi.org/10.1007/s00384-016-2687-2

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