title: The use of suction drains at burch colposuspension and postoperative infectious morbidity.
abstract: To evaluate whether the use of suction drains in the paravescical spaces is associated with the occurrence of postoperative infectious complications. Patients who underwent to a Burch colposuspension to treat urinary stress incontinence were included. Thirty-seven patients had the placement of suction drains in the paravescical spaces while 25 patients did not. Postoperative infectious morbidity was defined as the occurrence of at least one of the following events: febrile morbidity, sepsis, pelvic infections, severe wound infection and infected subfascial haematoma. Febrile morbidity was defined as two oral temperatures greater than 38 degrees C, taken at least 4 h apart, starting 24 h after the operation. The two groups were comparable in terms of demographic and clinical characteristics. The overall incidence of postoperative infectious morbidity was 22.6%. The proportion of patients with drains was higher in those groups who had postoperative complications than in patients with an uneventful postoperative period (78.6% vs 54.1%), although not statistically significant. The power to detect such a difference was only 39% (alpha=0.05). Seven patients developed a wound infection. Of these, five had the placement of suction drains. The placement of suction drains at Burch colposuspension seems to increase the risk of postoperative infectious complications. The possible benefits of suction drains must be counterbalanced with possible risks and, therefore, their routine use in Burch colposuspension is questionable.
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria - Del Ponte Hospital, Piazza Biroldi I, 21100 Varese, Italy. fabio.ghezzi@uninsubria.it
authors.forename: Fabio
authors.initials: F
authors.lastname: Ghezzi
authors.forename: Massimo
authors.initials: M
authors.lastname: Franchi
authors.forename: Marco
authors.initials: M
authors.lastname: Buttarelli
authors.forename: Maurizio
authors.initials: M
authors.lastname: Serati
authors.forename: Luigi
authors.initials: L
authors.lastname: Raio
authors.forename: Fasola
authors.initials: F
authors.lastname: Maddalena
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D004927:Escherichia coli Infections / Q000209:etiology; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000209:etiology; D013396:Suction / Q000009:adverse effects*; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000209:etiology*; D013536:Suture Techniques; D001743:Urinary Bladder / Q000601:surgery*; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects*
chemical_list: D000900:Anti-Bacterial Agents