title: Placement of prophylactic drains after laparotomy may increase infectious complications in neonates.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  Prophylactic drainage did not reduce the incidence of postoperative complications, and the placement of drains may possibly increase the incidence of infectious complications.
authors.affiliation: Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
authors.forename: Mikihiro
authors.initials: M
authors.lastname: Inoue
authors.forename: Keiichi
authors.initials: K
authors.lastname: Uchida
authors.forename: Kohei
authors.initials: K
authors.lastname: Otake
authors.forename: Yuhki
authors.initials: Y
authors.lastname: Koike
authors.forename: Yoshinaga
authors.initials: Y
authors.lastname: Okugawa
authors.forename: Minako
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Mohri
authors.forename: Chikao
authors.initials: C
authors.lastname: Miki
authors.forename: Masato
authors.initials: M
authors.lastname: Kusunoki
mesh_terms: D004322:Drainage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007239:Infections / Q000453:epidemiology* / Q000209:etiology*; D007813:Laparotomy; D008297:Male; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology*; D011446:Prospective Studies