Efficacy of Subcutaneous Closed Suction Drain in Reduction of The Post-Operative Surgical Site Infection in Tertiary Level Hospital in Salem

Abstract

Background: Surgical Site Infections (SSIs) are among the most common postoperative complications, particularly in emergency laparotomies, contributing to increased morbidity, prolonged hospital stays, and higher healthcare costs. The use of subcutaneous closed suction drains has been proposed as a preventive measure to reduce fluid accumulation, minimize bacterial proliferation, and improve overall wound healing. However, the effectiveness of this intervention remains a subject of debate.

Objective: This study aimed to evaluate whether the use of subcutaneous closed suction drains significantly reduces the incidence of SSIs in patients undergoing emergency laparotomy surgeries at a tertiary-level hospital in Salem.

Methods: A prospective comparative study was conducted among 100 patients undergoing emergency laparotomy. Participants were randomly assigned to two groups: the case group (n=50), in which a subcutaneous closed suction drain was placed before skin closure, and the control group (n=50), in which no drain was used. Patients aged <18 or >80 years, those with immunocompromised conditions (HIV, radiotherapy, chemotherapy, diabetes), and those undergoing repeat laparotomies were excluded. Data were collected on demographic characteristics, diagnosis, intraoperative contamination, surgical site infections, and postoperative outcomes. Statistical analysis was performed using SPSS software, with p-values < 0.05 considered statistically significant.

Results: The mean age of the study participants was 43.7 ± 17.09 years (range: 16–74 years), with a male predominance (60% males, 40% females). The incidence of Surgical Site Infections (SSI) was significantly lower in the subcutaneous drain group (12.5%) compared to the non-drain group (71.15%) (p < 0.001). The mean postoperative hospital stay was comparable between groups (11.85 ± 6.47 days vs. 11.46 ± 5.61 days; p = 0.746). Microbiological analysis revealed that patients with subcutaneous drains had a higher proportion of sterile cultures (93.75%) and a lower incidence of bacterial growth, including Staphylococcus aureus (4.16% vs. 34.61%), Escherichia coli (0% vs. 21.1%), and Klebsiella (2.08% vs. 17.3%) in comparison to the non-drain group.

Conclusion: The findings suggest that subcutaneous closed suction drains significantly reduce the incidence of SSIs in emergency laparotomies without prolonging hospital stay. This intervention also minimizes bacterial colonization, making it an effective strategy for reducing postoperative complications. Implementing routine use of subcutaneous drains in high-risk surgical cases may help improve patient outcomes and reduce healthcare burdens.