title: A prospective randomized controlled trial of subcutaneous passive drainage for the prevention of superficial surgical site infections in open and laparoscopic colorectal surgery.
abstract: BACKGROUND
  A number of studies have evaluated the effects of subcutaneous drainage during digestive surgery. All of the previous studies assessed the usefulness of active-suctioning drain, including two randomized controlled studies which found no benefit for the placement of active-suctioning drains in digestive surgery. The utility of passive drainage has not been evaluated previously. The purpose of this study was to evaluate the efficacy of subcutaneous passive drainage system for preventing surgical site infections during major colorectal surgery.
  
  
  METHODS
  A total of 263 patients who underwent major colorectal surgery were enrolled in this study. Patients were randomly assigned to receive subcutaneous passive drainage or no drainage. The primary outcome measured was the incidence of superficial surgical site infections. The secondary outcomes measured were the development of hematomas, seromas, and wound dehiscence.
  
  
  RESULTS
  Finally, a total of 246 patients (124 underwent passive drainage, and 122 underwent no drainage) were included in the analysis after randomization. There was a significant difference in the incidence of superficial surgical site infections between patients assigned to the passive drainage and no drainage groups (3.2 % vs 9.8 %, respectively, P = 0.041). There were no cases that developed a hematoma, seroma, or wound dehiscence in either group. A subgroup analysis revealed that male gender, age ≥75 years, diabetes mellitus, American Society of Anesthesiologists (ASA) status ≥2, blood loss ≥100 ml, and open access were factors that were associated with a beneficial effect of subcutaneous passive drainage.
  
  
  CONCLUSIONS
  Subcutaneous passive drainage provides benefits over no drainage in patients undergoing major colorectal surgery.
authors.affiliation: Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan, masakatsunumata@hotmail.co.jp.
authors.forename: Masakatsu
authors.initials: M
authors.lastname: Numata
authors.forename: Teni
authors.initials: T
authors.lastname: Godai
authors.forename: Junya
authors.initials: J
authors.lastname: Shirai
authors.forename: Kazuteru
authors.initials: K
authors.lastname: Watanabe
authors.forename: Daisuke
authors.initials: D
authors.lastname: Inagaki
authors.forename: Shinichi
authors.initials: S
authors.lastname: Hasegawa
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Sato
authors.forename: Takashi
authors.initials: T
authors.lastname: Oshima
authors.forename: Shoichi
authors.initials: S
authors.lastname: Fujii
authors.forename: Chikara
authors.initials: C
authors.lastname: Kunisaki
authors.forename: Norio
authors.initials: N
authors.lastname: Yukawa
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Rino
authors.forename: Masataka
authors.initials: M
authors.lastname: Taguri
authors.forename: Satoshi
authors.initials: S
authors.lastname: Morita
authors.forename: Munetaka
authors.initials: M
authors.lastname: Masuda
mesh_terms: D000368:Aged; D003106:Colon / Q000601:surgery*; D004322:Drainage / Q000379:methods*; D005260:Female; D006406:Hematoma / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012007:Rectum / Q000601:surgery*; D012307:Risk Factors; D049291:Seroma / Q000209:etiology / Q000517:prevention & control; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000517:prevention & control; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome