Recent evidence for subcutaneous drains to prevent surgical site infections after abdominal surgery:A systematic review and metaanalysis  

作　　者：Tomohiro Ishinuki Hiroji Shinkawa Keita Kouzu Seiichi Shinji Erika Goda Toshio Ohyanagi Masahiro Kobayashi Motomu Kobayashi Katsunori Suzuki Yuichi Kitagawa Chizuru Yamashita Yasuhiko Mohri Junzo Shimizu Motoi Uchino Seiji Haji Masahiro Yoshida Hiroki Ohge Toshihiko Mayumi Toru Mizuguchi 

机构地区：[1]Department of Nursing,Surgical Sciences,Sapporo Medical University,Sapporo 060-8556,Hokkaido,Japan [2]Department of Hepatobiliary-Pancreatic Surgery,Osaka Metropolitan University Graduate School of Medicine,Abeno-Ku 545-0051,Japan [3]Department of Surgery,National Defense Medical College,Tokorozawa 359-8513,Japan [4]Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery,Nippon Medical School,Tokyo 113-8602,Japan [5]Department of Nursing,Japan Health Care University,Sapporo 062-0053,Japan [6]Department of Liberal Arts and Sciences,Center for Medical Education,Sapporo Medical University,Sapporo 060-8556,Japan [7]Department of Clinical Pharmacokinetics,Research and Education Center for Clinical Pharmacy,Kitasato University,Tokyo 108-8641,Japan [8]Department of Anesthesiology,Hokushinkai Megumino Hospital,Eniwa 061-1395,Japan [9]Department of Infectious Disease Medicine,School of Medicine,University of Occupational and Environmental Health,Kitakyushu 807-8555,Japan [10]Department of Gastrointestinal Surgery,National Center for Geriatrics and Gerontology,Obu 474-8511,Japan [11]Department of Anesthesiology and Critical Care Medicine,Fujita Health University,Toyoake 470-1192,Japan [12]Department of Gastrointestinal Surgery,Mie Prefectural General Medical Center,Yokkaich 510-8561,Japan [13]Department of Surgery,Toyonaka Municipal Hospital,Toyonaka 560-8565,Japan [14]Department of Gastroenterological Surgery,Hyogo Medical University,Nishinomiya 663-8501,Japan [15]Department of Surgery,Soseikai General Hospital,Kyoto 612-8473,Japan [16]Department of Hepato-Biliary-Pancreatic&Gastrointestinal Surgery,International University of Health and Welfare,Ichikawa 272-0827,Japan [17]Department of Infectious Disease,Hiroshima University Hospital,Hiroshima 734-8551,Japan [18]Department of Intensive Care Unit,Chukyo Hospital,Japan Community Health Care Organization,Nagoya 457-8510,Japan

出　　处：《World Journal of Gastrointestinal Surgery》2023年第12期2879-2889,共11页世界胃肠外科杂志（英文版）（电子版）

基　　金：Supported by Grants-in-Aid from JSPS KAKENHI,No.JP 21K10715 and No.JP 20K10404;Northern Advancement Center for Science&Technology,No.T-2-2;the Yasuda Medical Foundation,No.31010316;the Okawa Foundation for Information and Telecommunications,No.41111042;Taiju Life Social Welfare Foundation,No.50811490;Japan Keirin Autorace Foundation,No.2023M-378;Project Mirai Cancer Research Grants,No.31010269;Takahashi Industrial and Economic Research Foundation,No.50411278;Sapporo Doto Hospital,No.50311211;Noguchi Hospital,No.40310551;Doki-kai Tomakomai Hospital,No.40710739;Tsuchida Hospital,No.50811478.

摘　　要：BACKGROUND Surgical site infections(SSIs)increase mortality,hospital stays,additional medical treatment,and medical costs.Subcutaneous drains prevent SSIs in gynecological and breast surgeries;however,their clinical impact in abdominal surgery remains unclear.AIM To investigate whether subcutaneous drains were beneficial in abdominal surgery using a systematic review and meta-analysis.METHODS The database search used PubMed,MEDLINE,and the Cochrane Library.The following inclusion criteria were set for the systematic review:(1)Randomized controlled trial studies comparing SSIs after abdominal surgery with or without subcutaneous drains;and(2)Studies that described clinical outcomes,such as SSIs,seroma formation,the length of hospital stays,and mortality.RESULTS Eight studies were included in this meta-analysis.The rate of total SSIs was significantly lower in the drained group(54/771,7.0%)than in the control group(89/759,11.7%),particularly in gastrointestinal surgery.Furthermore,the rate of superficial SSIs was slightly lower in the drained group(31/517,6.0%)than in the control group(49/521,9.4%).No significant differences were observed in seroma formation between the groups.Hospital stays were shorter in the drained group than in the control group.CONCLUSION Subcutaneous drains after abdominal surgery prevented SSIs and reduced hospital stays but did not significantly affect seroma formation.The timing of drain removal needs to be reconsidered in future studies.

关 键 词：Abdominal surgery MORTALITY Seroma formation Subcutaneous drain Surgical site infections 

分 类 号：R656[医药卫生—外科学]