Department of General Surgery, Emergency Department - Emergency and Trauma Surgery Division, Umberto I University Hospital, Sapienza University of Rome, Viale del Policlinico 155, 00183, Rome, Italy.
Division of General and Minimally Invasive Surgery, Misericordia Hospital, Grosseto, Italy.
Langenbecks Arch Surg. 2019 Sep;404(6):663-668. doi: 10.1007/s00423-019-01813-x. Epub 2019 Aug 29.
The role of subcutaneous prophylactic drainage in preventing postoperative abdominal wound complications is still controversial. We aimed to elucidate whether any difference in the incidence of surgical site infection (SSI) exists between patients with or without subcutaneous suction drain following clean-contaminated abdominal surgery.
PubMed, EMBASE, and the CENTRAL were systematically searched for randomized controlled trials (RCT) comparing drained with undrained surgeries featuring gastrointestinal (GI) tract opening. The aim of the analysis was to assess the incidence of wound infection. A meta-analysis of relevant studies was performed using RevMan 5.3.
A total of 8 studies, including 2833 patients, were considered eligible to collect data necessary. Globally, 187 patients (83 drained versus 104 undrained) experienced some SSI during the postoperative period. The use of subcutaneous suction drains did not exhibit any significant differences between drained and undrained patients in developing SSI (odds ratio 0.76, 95% CI 0.56-1.02; p = 0.07).
According to the available, high-level evidence, the use of subcutaneous drains should not be encouraged on a routine basis, as it does not confer any advantage in preventing postoperative wound infection following clean-contaminated abdominal surgery. However, this does not exclude that there might be a benefit in a specific risk group of patients.
皮下预防性引流在预防术后腹部伤口并发症方面的作用仍存在争议。我们旨在阐明在清洁污染性腹部手术后，接受或不接受皮下引流的患者之间，手术部位感染（SSI）的发生率是否存在差异。
系统地检索了 PubMed、EMBASE 和 CENTRAL 中的随机对照试验（RCT），比较了胃肠道（GI）切开的引流与未引流手术。分析的目的是评估伤口感染的发生率。使用 RevMan 5.3 对相关研究进行了荟萃分析。
共有 8 项研究，包括 2833 名患者，被认为有资格收集必要的数据。总体而言，187 名患者（引流组 187 名，未引流组 104 名）在术后期间出现了一些 SSI。使用皮下抽吸引流管并没有在发生 SSI 方面显示出引流和未引流患者之间的显著差异（优势比 0.76，95%CI 0.56-1.02；p=0.07）。
根据现有的高水平证据，不应该常规鼓励使用皮下引流管，因为它不能在预防清洁污染性腹部手术后的术后伤口感染方面带来任何优势。然而，这并不排除在特定的高危患者群体中可能存在获益。
