title: A prospective analysis of the association between indwelling surgical drains and surgical site infection in plastic surgery.
abstract: BACKGROUND
  Many surgeons fear that closed-suction drains serve as a portal for bacterial entry into surgical spaces. Despite a lack of supporting evidence, postoperative antibiotics are often prolonged while drains remain in place.
  
  
  METHODS
  Medical records of all patients who underwent intraoperative Jackson-Pratt drain placement and sterile removal over a 12-month period were prospectively analyzed.
  
  
  RESULTS
  Fifty-four patients with 101 drains were included. Drains were in place for 5 to 43 days [mean (SD), 13.5 (6.3) days]. Sixty-three percent of drains had positive cultures. All patients received perioperative antibiotics. Thirty-nine patients received postoperative antibiotics [mean (SD), 13.8 (13.8) days]. There were 2 cases of cellulitis. One patient required reoperation.
  
  
  CONCLUSIONS
  Sixty-six drains (65.3%) were placed in the presence of prosthetic material. Although nearly two thirds of drains were colonized with bacteria, our wound infection rate was extremely low (5.6%). Thus, closed-suction drains may be left in place for an extended period without increasing the risk of infection, even in the presence of prosthetic material.
authors.affiliation: From the *Division of Plastic Surgery, Weill Cornell Medical College, New York, NY; and †School of Medicine, New York University, New York, NY.
authors.forename: Alyssa J
authors.initials: AJ
authors.lastname: Reiffel
authors.forename: Lindsay A
authors.initials: LA
authors.lastname: Pharmer
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Weinstein
authors.forename: Jason A
authors.initials: JA
authors.lastname: Spector
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002408:Catheters, Indwelling / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods*; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D013396:Suction / Q000295:instrumentation*; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control*; D014945:Wound Healing / Q000502:physiology*
chemical_list: D000900:Anti-Bacterial Agents