TY - JOUR
T1 - Placement of prophylactic drains after laparotomy may increase infectious complications in neonates
AU - Inoue, Mikihiro
AU - Uchida, Keiichi
AU - Otake, Kohei
AU - Koike, Yuhki
AU - Okugawa, Yoshinaga
AU - Kobayashi, Minako
AU - Mohri, Yasuhiko
AU - Miki, Chikao
AU - Kusunoki, Masato
PY - 2011/9
Y1 - 2011/9
N2 - Purpose 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%; nondrainage, 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). Conclusion Prophylactic drainage did not reduce the incidence of postoperative complications, and the placement of drains may possibly increase the incidence of infectious complications.
AB - Purpose 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%; nondrainage, 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). Conclusion Prophylactic drainage did not reduce the incidence of postoperative complications, and the placement of drains may possibly increase the incidence of infectious complications.
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U2 - 10.1007/s00383-011-2905-5
DO - 10.1007/s00383-011-2905-5
M3 - Article
C2 - 21512810
AN - SCOPUS:80054930097
SN - 0179-0358
VL - 27
SP - 975
EP - 979
JO - Pediatric Surgery International
JF - Pediatric Surgery International
IS - 9
ER -