T-tube suction drainage and/or prophylactic two-dose metronidazole in abdominal hysterectomy.

The efficacy of a two-dose perioperative course of rectally administered metronidazole and/or suction drainage of the vaginal vault in preventing febrile and infectious morbidity was evaluated in a randomized study of 198 patients undergoing abdominal hysterectomy. When compared with the control values, the incidence of febrile morbidity was significantly reduced (from 49% to 10%, 24.5%, and 10% respectively) in the groups treated with metronidazole, T-tube suction drainage, and a combination of the two prophylactic measures. The incidence of infectious morbidity was significantly reduced by using prophylactic metronidazole alone or in combination with suction drainage, but the reduction was most significant in the group treated with metronidazole alone. In the group managed with suction drainage alone, no reduction in infectious morbidity was found. The rate of postoperative urinary tract infection was significantly lower in the group treated with metronidazole alone as compared with the control group. No side effects of metronidazole were encountered.