Utility of a Chimney-Type Penrose Drain for Prevention of Superficial Surgical Site Infection in Cases of Lower Gastrointestinal Perforation

Abstract

The objective of the present study was to investigate the utility of placing a chimney-type (stacked subcutaneous Penrose) drain to prevent surgical site infection (SSI), and particularly superficial SSI (sSSI), following surgery performed for lower gastrointestinal perforation. Subjects and methods: Our subjects were 93 patients who underwent emergency surgery after being diagnosed as having lower gastrointestinal perforation at our hospital from October 2009 to August 2020. All patients not meeting the inclusion criteria were excluded from the study. Subjects were divided into three groups (listed in chronological order): group C, 36 subjects with no drain inserted from 2009 to 2012; group B, 39 subjects in whom closed negative-pressure drains were placed from 2012 to 2017; and group A, 18 subjects in whom chimney-type drains were placed from 2017 to 2020. We retrospectively investigated patient factors, surgical factors, postoperative drain indwelling time, whether sSSI onset occurred and days until sSSI onset. sSSI was diagnosed based on the criteria published by the Japan Nosocomial Infection Surveillance (JANIS) program run by the Japanese Ministry of Health, Labour and Welfare. Results: The incidence of sSSI was lower in group B than in group C, but the difference was not statistically significant. The incidence of sSSI was significantly lower in group A than in group C (5.6% vs 33.3%, p=0.04) and was also lower in group A than in group B, but not statistically significantly so (5.6% vs 20.5%, p=0.24) Discussion: We believe that insertion of a chimney-type drain is useful for preventing sSSI in patients who have undergone surgery to treat lower gastrointestinal perforation.