Mallaiah Bhaskar, K Bhavana Chinmayee, J Ramachandra
General Surgery, Kempegowda Institute of Medical Sciences, Bengaluru, IND.
Surgery, Kempegowda Institute of Medical Sciences, Bengaluru, IND.
Cureus. 2025 May 16;17(5):e84247. doi: 10.7759/cureus.84247. eCollection 2025 May.
Aim This study aimed to compare the effectiveness of subcutaneous negative suction drainage vs. no drainage in reducing postoperative complications following emergency laparotomy for peritonitis. Objective The primary objective of this study was to evaluate the effect of subcutaneous negative pressure closure on various postoperative outcomes in patients undergoing emergency surgery. Specifically, the study aims to assess its impact on the incidence of surgical site infection (SSI), wound dehiscence, the need for secondary suturing, and the duration of hospital stay. Additionally, the study seeks to determine whether the observed SSIs are primarily attributable to intra-abdominal infections or are a result of hospital-acquired cross infections. Materials and methods A prospective comparative study was conducted on 60 patients diagnosed with peritonitis who underwent emergency laparotomy. They were randomly assigned into two groups of 30 patients each: Group A (with subcutaneous negative suction drain) and Group B (without drain). In Group A, drain fluid was analyzed for infection characteristics, while wound discharge from both groups was assessed microbiologically, where present. Results Group A included 21 males (70%) and nine females (30%), while Group B had 26 males (86%) and four females (13%). Midline vertical incisions were used in 90% of cases, with the remaining 10% receiving right paramedian incisions. Discharge from the incision site was observed in five patients (16%) in Group A and 13 patients (43%) in Group B (p = 0.024). SSIs occurred in five patients (16.67%) in Group A and in eight patients (26%) in Group B. Seroma formation was observed in five patients (16.67%) in Group B, but none in Group A. No significant differences were noted in wound dehiscence, need for secondary suturing, or duration of hospital stay between the groups. Conclusion Subcutaneous negative suction drainage significantly reduced the incidence of SSI, seroma formation, and discharge from the incision site following emergency laparotomy for peritonitis. This may lower the risk of wound complications and postoperative morbidity. Further randomized controlled trials are recommended to validate these findings.
目的 本研究旨在比较皮下负压引流与不引流在降低腹膜炎急诊剖腹术后并发症方面的有效性。
目的 本研究的主要目的是评估皮下负压封闭对急诊手术患者各种术后结局的影响。具体而言，该研究旨在评估其对手术部位感染（SSI）发生率、伤口裂开、二次缝合需求以及住院时间的影响。此外，该研究试图确定观察到的手术部位感染主要是由腹腔内感染引起还是医院获得性交叉感染的结果。
材料与方法 对60例诊断为腹膜炎并接受急诊剖腹手术的患者进行了一项前瞻性对照研究。他们被随机分为两组，每组30例患者：A组（采用皮下负压引流）和B组（不引流）。在A组中，对引流液进行感染特征分析，同时对两组有伤口渗出的患者进行微生物学评估。
结果 A组包括21例男性（70%）和9例女性（30%），而B组有26例男性（86%）和4例女性（13%）。90%的病例采用正中垂直切口，其余10%采用右侧旁正中切口。A组有5例患者（16%）出现切口部位渗出，B组有13例患者（4）出现切口部位渗出（p = 0.024）。A组有5例患者（16.67%）发生手术部位感染，B组有8例患者（26%）发生手术部位感染。B组有5例患者（16.67%）出现血清肿形成，而A组未观察到血清肿形成。两组在伤口裂开、二次缝合需求或住院时间方面未观察到显著差异。
结论 皮下负压引流显著降低了腹膜炎急诊剖腹术后手术部位感染、血清肿形成和切口部位渗出的发生率。这可能会降低伤口并发症和术后发病率的风险。建议进行进一步的随机对照试验以验证这些发现。
