EMERGENCY LAPAROTOMY;

WITH OR WITHOUT DRAINS WHICH OPTION TO SELECT FOR PREVENTION OF DEEP SURGICAL SITE INFECTION

Abstract

Objectives: Emergency laparotomy followed by placement of drain is a
common procedure in tertiary care hospitals but there are contradictory evidences regarding
its association with deep surgical site infection. Thus current study was planned with an
objective to compare the frequency of deep surgical site infection among patients with and
without postoperative drains after undergoing an emergency laparotomy at a tertiary care
hospital. Data source: Primary data based on patients undergoing emergency laparotomy at
tertiary care hospital. Study design: Randomized control trial. Setting: Department of surgical
unit-III, Jinnah Hospital Lahore. Duration of study: Study was conducted from January 2016
to December 2016. Subjects & methods: About 400 patients of 15-70 years undergoing
emergency laparotomy were selected using non-probability consecutive sampling technique
after informed consent. Information regarding their demographic characteristics and study
variable was recorded in a structured proforma. All the subjects were randomized into two
groups i.e. with and without post-operative drains using table of random number. Frequency
of deep surgical site infection was assessed on 7th post operative day and data was analyzed
using SPSS version 21.0. Result: The mean age of patients was 38.92 ± 6.246 years with
about 229(57.2%) male patients. The frequency of development of deep surgical site infection
in first postoperative week was 51(12.7%) overall, with 24(12%) patients in the group of postoperative
drains and 27(13.5%) patients without post-operative drains. The differences between
two groups were statistically insignificant. Moreover, it was not significantly related to the age,
gender, duration of stay in the hospital and smoking. Conclusion: It can be concluded from the
study that there is no significantly increased risk of deep surgical site wound infection with or
without placement of drain. So it is reasonable and safe approach to place a drain in the wound
for the early detection of bleeding or leakage to decrease the morbidity and complication in the
patients.