TY - JOUR
T1 - Adverse Events of Surgical Drain Placement
T2 - An Analysis of the NSQIP Database
AU - Talwar, Abhinav
AU - Bansal, Ashir
AU - Knight, Gabriel
AU - Caicedo, Juan Carlos
AU - Riaz, Ahsun
AU - Salem, Riad
N1 - Publisher Copyright:
© The Author(s) 2023.
PY - 2024/4
Y1 - 2024/4
N2 - Background: Surgical site drainage is important to prevent hematoma, seroma, and abscess formation. However, the placement of drain placement also predispose patients to several postoperative complications. The aim of this study is to clarify the risk-benefit profile of surgical drain placement. Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Procedure-Targeted Databases were used to identify patients who underwent hepatectomy, pancreatectomy, nephrectomy, cystectomy, and prostatectomy. Patients who underwent each procedure were divided into 2 groups based on intraoperative drain placement. Propensity score-matched cohorts of these 2 groups were compared in terms of postoperative adverse events, readmission, reoperation, and length of stay. Results: Hepatectomy patients with drains experienced organ space infections (P <.001), sepsis (P <.001), and readmission (P =.021) more often than patients without drains. Patients who underwent pancreatectomy and had drains placed experienced wound dehiscence less frequently than those without drains (P =.04). For hepatectomy, pancreatectomy, nephrectomy, and prostatectomy populations, patients with drains had longer lengths of stay (P <.05). Matched populations across all procedures did not differ in terms of reoperation rate. Discussion: Prophylactic surgical drain placement may be associated with increased infectious complications and prolonged length of stay. Further studies are needed to elucidate the complete adverse event profile of surgical drains. Nonetheless, outcomes may be improved with better patient selection or advancements in drain technology.
AB - Background: Surgical site drainage is important to prevent hematoma, seroma, and abscess formation. However, the placement of drain placement also predispose patients to several postoperative complications. The aim of this study is to clarify the risk-benefit profile of surgical drain placement. Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Procedure-Targeted Databases were used to identify patients who underwent hepatectomy, pancreatectomy, nephrectomy, cystectomy, and prostatectomy. Patients who underwent each procedure were divided into 2 groups based on intraoperative drain placement. Propensity score-matched cohorts of these 2 groups were compared in terms of postoperative adverse events, readmission, reoperation, and length of stay. Results: Hepatectomy patients with drains experienced organ space infections (P <.001), sepsis (P <.001), and readmission (P =.021) more often than patients without drains. Patients who underwent pancreatectomy and had drains placed experienced wound dehiscence less frequently than those without drains (P =.04). For hepatectomy, pancreatectomy, nephrectomy, and prostatectomy populations, patients with drains had longer lengths of stay (P <.05). Matched populations across all procedures did not differ in terms of reoperation rate. Discussion: Prophylactic surgical drain placement may be associated with increased infectious complications and prolonged length of stay. Further studies are needed to elucidate the complete adverse event profile of surgical drains. Nonetheless, outcomes may be improved with better patient selection or advancements in drain technology.
KW - critical care
KW - general surgery
KW - surgical infection
KW - surgical quality
KW - wound healing
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U2 - 10.1177/00031348231192063
DO - 10.1177/00031348231192063
M3 - Article
C2 - 37490700
AN - SCOPUS:85165923847
SN - 0003-1348
VL - 90
SP - 672
EP - 681
JO - American Surgeon
JF - American Surgeon
IS - 4
ER -