title: Effects of subcutaneous drain for the prevention of incisional SSI in high-risk patients undergoing colorectal surgery.
abstract: BACKGROUND
  We have previously demonstrated that the risk of incisional surgical site infection (SSI) increases with obesity and that the most useful predictor of incisional SSI is the thickness of subcutaneous fat. Based on this finding, we have recently attempted a closure technique in surgery for the obese in which a subcutaneous drain is inserted for the prevention of incisional SSI. The aim of this study was to assess the utility of a subcutaneous drain for preventing incisional SSI in patients undergoing colorectal surgery who are at high risk for incisional SSI.
  
  
  METHODS
  Seventy-nine patients who underwent colorectal resection with high risk for incisional SSI, including patients with obesity (thick subcutaneous fat tissue, >20 mm) and those undergoing emergency operations, were enrolled in this study. The clinical features of these cases with or without a subcutaneous drain were reviewed, and statistical analysis was performed.
  
  
  RESULTS
  In these high-risk cases, the overall incidence of incisional SSI was 27.8%. The incidences of incisional SSI in these cases with or without a subcutaneous drain were 14.3% and 38.6%, respectively. Our results suggest that subcutaneous drains are effective for preventing incisional SSI in patients with thick subcutaneous fat in colorectal surgery.
  
  
  CONCLUSIONS
  Therefore, incisional SSI surveillance for obese patients should be performed separately, which should lead to a further reduction in incisional SSIs.
authors.affiliation: Department of General Surgical Science, Graduate School of Medicine, Gunma University, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan. ftakaaki@med.gunma-u.ac.jp
authors.forename: Takaaki
authors.initials: T
authors.lastname: Fujii
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Tabe
authors.forename: Reina
authors.initials: R
authors.lastname: Yajima
authors.forename: Satoru
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Soichi
authors.initials: S
authors.lastname: Tsutsumi
authors.forename: Takayuki
authors.initials: T
authors.lastname: Asao
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003107:Colorectal Surgery / Q000009:adverse effects*; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012307:Risk Factors; D050151:Subcutaneous Fat / Q000601:surgery*; D013530:Surgical Wound Infection / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control*