Efficacy of Subcutaneous Closed Suction Drain In Reducing SSI After Exploration of the Common Bile Duct
Keywords:
Subcutaneous suction drain, Surgical site infection, Open choledocholithotomyAbstract
Introduction: In surgical practice, surgical site infections (SSIs) continue to be a significant issue. The SSI rate following general abdominal surgery is still more than 15% despite preventive measures including antibiotic prophylaxis and anti-septic skin preparation. Following an open choledocholithotomy, this complication is also frequent. There is little information about the benefits of wound drainage in open choledocholithotomy, despite numerous trials demonstrating its effectiveness in lowering infection. The purpose of this study was to evaluate the efficacy of subcutaneous drain placement in reducing superficial SSI following open choledocholithotomy.
Methods: 44 patients who underwent open choledocholithotomy between January 2022 and December 2022 were included in the study after convenience sampling. Two groups of patients were created. Twenty-two patients (group I) had a subcutaneous drain, while 22 patients (group II) had no subcutaneous closed suction drain. All patients were diagnosed clinically and by doing imaging followed by open procedure of conventional choledocholithotomy. In the cohort with subcutaneous drain, daily subcutaneous drain collection was documented. Following surgery, each patient was assessed for the presence of wound dehiscence, superficial SSIs, and wound seromas and compared. The statistical program SPSS 22 Windows version 10 was applied for data analysis and presentation.
Results: Most of the patients were female 27 (61.36%). Among them 17(38.64%) cases were present in the 41-50 years of age group. Commonest risk factors were diabetes 7(31.82%), CKD 4(18.18%) and hypoalbuminemia 8(36.36%) in case groups. Surgical site infection (SSI) took place in 4(18.18%) patients among the group with subcutaneous drain and 13(59.09%) among the control cohort. Available organisms were Staphylococcus Aureus 8(36.36%) and Escherichia Coli 6(13.64%) in both groups, isolated from both bile culture and wound swab culture.
Conclusion: The prevention of superficial surgical site infection was positively impacted by the installation of a drain in the wound following an open choledocholithotomy by lowering the rate of SSIs and hospital stays.
Journal of Surgical Sciences 2024;28(2): 49-54
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