PURPOSE: The aim of this study was to determine if the placement of prophylactic drains influences the incidence of postoperative adverse events in neonates. METHODS: Neonatal patients undergoing laparotomy between April 2000 and December 2007 were prospectively assigned to aggressive peritoneal cavity lavage, without the placement of prophylactic drains, before abdominal closure (non-drainage group, n = 111). The historical control group consisted of neonates who underwent laparotomy with routine prophylactic drain placement between January 1993 and March 2000 (drainage group, n = 87). The incidence of postoperative adverse events was compared between the two groups. RESULTS: There were no significant differences in the incidence of overall complications (drainage, 48%; non-drainage, 36%: p = 0.08), infectious complications (drainage, 34%; non-drainage, 26%: p = 0.20) or surgical site infections (drainage, 20%; non-drainage, 14%: p = 0.25) between the two groups. In the subgroup analysis, the incidences of total postoperative complications and infectious complications were significantly higher in the drainage group compared with the non-drainage group for upper gastrointestinal tract operations (52 vs. 20%; 39 vs. 6.7%) (p = 0.04 and 0.02, respectively). CONCLUSION: Prophylactic drainage did not reduce the incidence of postoperative complications, and the placement of drains may possibly increase the incidence of infectious complications.
PURPOSE: The aim of this study was to determine if the placement of prophylactic drains influences the incidence of postoperative adverse events in neonates. METHODS: Neonatal patients undergoing laparotomy between April 2000 and December 2007 were prospectively assigned to aggressive peritoneal cavity lavage, without the placement of prophylactic drains, before abdominal closure (non-drainage group, n = 111). The historical control group consisted of neonates who underwent laparotomy with routine prophylactic drain placement between January 1993 and March 2000 (drainage group, n = 87). The incidence of postoperative adverse events was compared between the two groups. RESULTS: There were no significant differences in the incidence of overall complications (drainage, 48%; non-drainage, 36%: p = 0.08), infectious complications (drainage, 34%; non-drainage, 26%: p = 0.20) or surgical site infections (drainage, 20%; non-drainage, 14%: p = 0.25) between the two groups. In the subgroup analysis, the incidences of total postoperative complications and infectious complications were significantly higher in the drainage group compared with the non-drainage group for upper gastrointestinal tract operations (52 vs. 20%; 39 vs. 6.7%) (p = 0.04 and 0.02, respectively). CONCLUSION: Prophylactic drainage did not reduce the incidence of postoperative complications, and the placement of drains may possibly increase the incidence of infectious complications.
Authors: Martin L Blakely; Kevin P Lally; Scott McDonald; Rebeccah L Brown; Douglas C Barnhart; Richard R Ricketts; W Raleigh Thompson; L R Scherer; Michael D Klein; Robert W Letton; Walter J Chwals; Robert J Touloukian; Arlett G Kurkchubasche; Michael A Skinner; R Lawrence Moss; Mary L Hilfiker Journal: Ann Surg Date: 2005-06 Impact factor: 12.969
Authors: A Toki; K Ogura; T Horimi; H Tokuoka; T Todani; Y Watanabe; S Uemura; N Urushihara; T Noda; Y Sato Journal: Surg Today Date: 1995 Impact factor: 2.549