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A prospective randomized controlled trial of subcutaneous passive drainage for the prevention of superficial surgical site infections in open and laparoscopic colorectal surgery

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Introduction

A number of studies have evaluated the effects of subcutaneous drainage during digestive surgery. All of the previous studies assessed the usefulness of active-suctioning drain, including two randomized controlled studies which found no benefit for the placement of active-suctioning drains in digestive surgery. The utility of passive drainage has not been evaluated previously. The purpose of this study was to evaluate the efficacy of subcutaneous passive drainage system for preventing surgical site infections during major colorectal surgery.

Patients and methods

A total of 263 patients who underwent major colorectal surgery were enrolled in this study. Patients were randomly assigned to receive subcutaneous passive drainage or no drainage. The primary outcome measured was the incidence of superficial surgical site infections. The secondary outcomes measured were the development of hematomas, seromas, and wound dehiscence.

Results

Finally, a total of 246 patients (124 underwent passive drainage, and 122 underwent no drainage) were included in the analysis after randomization. There was a significant difference in the incidence of superficial surgical site infections between patients assigned to the passive drainage and no drainage groups (3.2 % vs 9.8 %, respectively, P = 0.041). There were no cases that developed a hematoma, seroma, or wound dehiscence in either group. A subgroup analysis revealed that male gender, age ≥75 years, diabetes mellitus, American Society of Anesthesiologists (ASA) status ≥2, blood loss ≥100 ml, and open access were factors that were associated with a beneficial effect of subcutaneous passive drainage.

Conclusions

Subcutaneous passive drainage provides benefits over no drainage in patients undergoing major colorectal surgery.

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Acknowledgments

The authors would like to thank Y. Ishida, S. Shibuya, and T. Ishibashi for their secretarial assistance.

Conflicts of interest

We declare that there is no conflict of interest and that the trial was done independently of the producer.

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Authors and Affiliations

  1. Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan

    Masakatsu Numata, Teni Godai, Junya Shirai, Kazuteru Watanabe, Daisuke Inagaki, Shinichi Hasegawa, Takashi Oshima, Shoichi Fujii & Chikara Kunisaki

  2. Department of Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan

    Tsutomu Sato, Norio Yukawa, Yasushi Rino & Munetaka Masuda

  3. Department of Biostatistics and Epidemiology, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan

    Masataka Taguri & Satoshi Morita

  4. Department of Surgery, Hadano Red Cross Hospital, 1-1 Tatenodai, Hadano City, Kanagawa, 257-0017, Japan

    Masakatsu Numata

Authors
  1. Masakatsu Numata
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  2. Teni Godai
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  3. Junya Shirai
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  4. Kazuteru Watanabe
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  5. Daisuke Inagaki
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  6. Shinichi Hasegawa
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  7. Tsutomu Sato
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  8. Takashi Oshima
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  9. Shoichi Fujii
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  10. Chikara Kunisaki
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  11. Norio Yukawa
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  12. Yasushi Rino
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  13. Masataka Taguri
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  14. Satoshi Morita
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  15. Munetaka Masuda
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Corresponding author

Correspondence to Masakatsu Numata.

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Numata, M., Godai, T., Shirai, J. et al. A prospective randomized controlled trial of subcutaneous passive drainage for the prevention of superficial surgical site infections in open and laparoscopic colorectal surgery. Int J Colorectal Dis 29, 353–358 (2014). https://doi.org/10.1007/s00384-013-1810-x

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  • DOI: https://doi.org/10.1007/s00384-013-1810-x

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