Open AccessRole of Drain in the Wound for Prevention of Superficial Surgical Site Infection Following Open Choledocholithotomy
Author(s) -
Raka Mustary Khan,
Farzana Sultana,
Dr. Md. Oliul Islam,
Mohammad Kamruzzaman Bhuiyan,
Dr. Md. Sohel Rana,
Syeda Shahnaz Nasrullah,
Professor AHM Towhidul Alam Chowdhury,
Dr.Md. Abul Kalam Chowdhury
Publication year - 2022
Publication title -
sas journal of surgery
Language(s) - English
Resource type - Journals
ISSN - 2454-5104
DOI - 10.36347/sasjs.2022.v08i03.014
Subject(s) - medicine , surgery , wound dehiscence , surgical site infection , dehiscence , surgical wound , antibiotic prophylaxis , antibiotics , microbiology and biotechnology , biology
Background: Surgical site infections (SSIs) are still a major problem in surgical practice. Despite the preventive strategies such as antibiotic prophylaxis and anti-septic skin cleansing, the SSI rate remains above 15 % after general abdominal surgery. This complication is also common after open choledocholithotomy. Several studies have shown that wound drainage is beneficial for reducing infection; however, there is a paucity of data regarding its benefit in open choledocholithotomy. Objective: To assess the effectiveness of placing a drain in the subcutaneous plane in order to reduce superficial SSI after open choledocholithotomy. Methods: Following convenience sampling, a total of 44 patients who underwent open choledocholithotomy from March 2019 to July 2021 were included in the study. Patients were divided into two groups. A subcutaneous closed suction drain was inserted in 19 patients (group I) and no subcutaneous drain was placed in 25 patients (group II). Daily drain collection was recorded in the case group. All the patients were examined and evaluated postoperatively for detection of wound seromas, superficial SSIs, and wound dehiscence. Data analysis and presentation made by statistical software SPSS 22 windows version 10. Results: It was observed that 10.5% of patients had SSI in group I and 60.0% in group II. The difference was statistically significant (p=0.001) between the two groups. The mean postoperative hospital stay was 11.58±2.91 days in group I and 15.04±5.78 days in group II. The difference in length of postoperative hospital stay was statistically significant between the two groups. Organisms isolated from bile culture and wound swab culture both are dominated by Escherichia coli. Conclusion: The placement of a drain in the wound in open choledocholithotomy showed a positive impact on the prevention of superficial surgical site infection. It also significantly reduces the length of hospital stay and SSSI rate.