Intraperitoneal drain placement prolongs hospital stay and increases surgical site infection risk

The key findings of this study were as follows:

1. In all, 1805 patients from 22 countries were involved in the study (798 women, 44.2%; median age of 67.0 years).

2. The rate of drain placement was 51.9% (937 patients).

3. Drains were not related to lower rates or quicker identification of collections after matching.

4. Although drains were not linked to worse severe postoperative complications, they were linked to delayed hospital release and an increased risk of SSIs.

In conclusion, despite strong evidence and ERAS guidelines, this large multicenter, worldwide, prospective cohort research demonstrated that intraperitoneal drain placement is a widespread practice in elective colorectal surgery across the world. Surgeons should ensure that any drain implanted is expressly advised in the absence of unequivocal evidence of therapeutic benefit but evidence of possible damage to patients (with the rationale documented). Concerning the use of intraperitoneal drain implantation in elective colorectal surgery, de-implementation methods at the organizational and surgeon levels should be explored.

Reference:

Sgrò, A., Blanco-Colino, R., Ahmed, W., Brindl, N., Gujjuri, R., Lapolla, P., Mills, E., Pérez-Ajates, S., Soares, A., Varghese, C., Xu, W., McLean, K., Chapman, S., … Pusey, E. (2022). Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study. In British Journal of Surgery (Vol. 109, Issue 6, pp. 520–529). Oxford University Press (OUP). https://doi.org/10.1093/bjs/znac069