Emergency Laparotomy; With or Without Drains Which Option to Select for Prevention of Deep Surgical Site Infection

Abstract

ABSTRACT… Objectives: Emergency laparotomy followed by placement of drain is a common procedure in tertiary care hospitals but there are contradictory evidences regarding its association with deep surgical site infection. Thus current study was planned with an objective to compare the frequency of deep surgical site infection among patients with and without postoperative drains after undergoing an emergency laparotomy at a tertiary care hospital. Data source: Primary data based on patients undergoing emergency laparotomy at tertiary care hospital. Study design: Randomized control trial. Setting: Department of surgical unit-III, Jinnah Hospital Lahore. Duration of study: Study was conducted from January 2016 to December 2016. Subjects & methods: About 400 patients of 15-70 years undergoing emergency laparotomy were selected using non-probability consecutive sampling technique after informed consent. Information regarding their demographic characteristics and study variable was recorded in a structured proforma. All the subjects were randomized into two groups i.e. with and without post-operative drains using table of random number. Frequency of deep surgical site infection was assessed on 7 th post operative day and data was analyzed using SPSS version 21.0. Result: The mean age of patients was 38.92 ± 6.246 years with about 229(57.2%) male patients. The frequency of development of deep surgical site infection in first postoperative week was 51(12.7%) overall, with 24(12%) patients in the group of postoperative drains and 27(13.5%) patients without post-operative drains. The differences between two groups were statistically insignificant. Moreover, it was not significantly related to the age, gender, duration of stay in the hospital and smoking. Conclusion: It can be concluded from the study that there is no significantly increased risk of deep surgical site wound infection with or without placement of drain. So it is reasonable and safe approach to place a drain in the wound for the early detection of bleeding or leakage to decrease the morbidity and complication in the patients. Keywords:Deep Surgical Site Infection, Emergency Laparotomy, Postoperative Drains, Peritonitis