Ishinuki Tomohiro, Shinkawa Hiroji, Kouzu Keita, Shinji Seiichi, Goda Erika, Ohyanagi Toshio, Kobayashi Masahiro, Kobayashi Motomu, Suzuki Katsunori, Kitagawa Yuichi, Yamashita Chizuru, Mohri Yasuhiko, Shimizu Junzo, Uchino Motoi, Haji Seiji, Yoshida Masahiro, Ohge Hiroki, Mayumi Toshihiko, Mizuguchi Toru
Department of Nursing, Surgical Sciences, Sapporo Medical University, Sapporo 060-8556, Hokkaido, Japan.
Department of Hepatobiliary-Pancreatic Surgery, Osaka Metropolitan University Graduate School of Medicine, Abeno-Ku 545-0051, Japan.
World J Gastrointest Surg. 2023 Dec 27;15(12):2879-2889. doi: 10.4240/wjgs.v15.i12.2879.
Surgical site infections (SSIs) increase mortality, hospital stays, additional medical treatment, and medical costs. Subcutaneous drains prevent SSIs in gynecological and breast surgeries; however, their clinical impact in abdominal surgery remains unclear.
To investigate whether subcutaneous drains were beneficial in abdominal surgery using a systematic review and meta-analysis.
The database search used PubMed, MEDLINE, and the Cochrane Library. The following inclusion criteria were set for the systematic review: (1) Randomized controlled trial studies comparing SSIs after abdominal surgery with or without subcutaneous drains; and (2) Studies that described clinical outcomes, such as SSIs, seroma formation, the length of hospital stays, and mortality.
Eight studies were included in this meta-analysis. The rate of total SSIs was significantly lower in the drained group (54/771, 7.0%) than in the control group (89/759, 11.7%), particularly in gastrointestinal surgery. Furthermore, the rate of superficial SSIs was slightly lower in the drained group (31/517, 6.0%) than in the control group (49/521, 9.4%). No significant differences were observed in seroma formation between the groups. Hospital stays were shorter in the drained group than in the control group.
Subcutaneous drains after abdominal surgery prevented SSIs and reduced hospital stays but did not significantly affect seroma formation. The timing of drain removal needs to be reconsidered in future studies.
手术部位感染（SSIs）会增加死亡率、住院时间、额外的医疗治疗以及医疗费用。皮下引流可预防妇科和乳腺手术中的手术部位感染；然而，其在腹部手术中的临床影响仍不明确。
通过系统评价和荟萃分析来研究皮下引流在腹部手术中是否有益。
数据库检索使用了PubMed、MEDLINE和Cochrane图书馆。为该系统评价设定了以下纳入标准：（1）比较腹部手术有或无皮下引流后手术部位感染的随机对照试验研究；（2）描述临床结局的研究，如手术部位感染、血清肿形成、住院时间和死亡率。
八项研究纳入了该荟萃分析。引流组的总手术部位感染率（54/771，7.0%）显著低于对照组（89/759，11.7%），尤其是在胃肠手术中。此外，引流组的浅表手术部位感染率（31/517，6.0%）略低于对照组（49/521，9.4%）。两组之间在血清肿形成方面未观察到显著差异。引流组的住院时间比对照组短。
腹部手术后皮下引流可预防手术部位感染并缩短住院时间，但对血清肿形成无显著影响。未来研究需要重新考虑引流管拔除的时机。
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