345 Identifying Unmet Needs Concerning Luminal Device Insertion in Surgery - a Pan-Speciality Cross Sectional Survey and Qualitative Analysis

Aim Surgical drains and luminal devices play a crucial role across the healthcare sector. Drain placement in elective procedures has been questioned following the adoption of Enhanced Recovery After Surgery guidelines. This study aimed to investigate post-operative issues related to drains and luminal devices across surgical specialties. Method Clinicians with professional registration in the UK who insert luminal devices were eligible for inclusion. Data were collected through an electronic questionnaire distributed at a national health technology meeting with predefined questions generated through steering group consensus. A thematic qualitative analysis was performed. Results 40 participants across 13 specialities responded to the survey. 45%(n=18) were General Surgery; 32.5%(n=13) other surgical specialties, and 22.5%(n=9) were in medical specialties. Thematic Analysis elicited 3 central themes: (1) Indication for device, (2) method of securing device and (3) post-operative issues. The most common indications were prophylactic for anticipated blood loss in 55%(n=22) and therapeutic in 24%(n=10) for drainage or source control. 75%(n=30) of respondents utilised non-absorbable sutures for securing the device. Drain positioning issues were reported in 21% of respondents. Complications of poor wound healing, fistula formation, and infection were common in 22% along with complete drain displacement observed by 1/5. Patient discomfort secondary to drain insertion was reported in 38%. Conclusions This pilot study provides insight into the attitudes and practices of a common surgical intervention. These findings presented demonstrate a strong signal that further work is required in this area and will be used to inform future national collaborative studies.