Early Outcome of Laparotomy Wound Closure with or without Subcutaneous Suction Drain Following Repair of Duodenal Ulcer Perforation

Perforation peritonitis due to duodenal ulcer is the most common surgical emergency and is frequently associated with postoperative wound complications such as seroma, surgical site infection (SSI) and wound dehiscence. Although several preventive measures exist the optimal strategy for minimizing these complications remains unclear. This study aimed to evaluate whether placing a subcutaneous closed-suction drain during laparotomy reduces early wound complications following primary repair of duodenal ulcer perforation. This prospective comparative observational study was conducted in the Sylhet MAG Osmani Medical College Hospital from December 2022 to December 2023. A total of 100 consecutive patients undergoing emergency laparotomy for duodenal ulcer perforation were enrolled and allocated into two groups based on intraoperative wound-closure technique: Group A (primary closure without subcutaneous drain) and Group B (primary closure with subcutaneous closed-suction drain), with 50 patients in each group. Demographic data, operative findings, and postoperative outcomes were recorded. Seroma formation, wound dehiscence, SSI and duration of hospital stay were compared employing chi-square test, t-test, and logistic regression. The mean age of patients was 34.92 ± 6.09 years and 33.58 ± 5.87 years in Group A and Group B respectively. Seroma development was significantly lower with subcutaneous closed-suction drain placement compared with no drain (odds ratio [OR] = 0.317 [95% confidence interval, CI: 0.114–0.894]; p = 0.02713). SSI was also reduced in Group B (OR = 0.255319 [95% CI: 0.065–0.992]; p = 0.037). Wound dehiscence occurred less frequently with drains (OR = 0.107 [95% CI: 0.012–0.892]; p = 0.0144) than without. Hospital stay was significantly shorter in Group B than Group A (8.39 ± 3.53 vs. 12.42 ± 2.95 days). Subcutaneous suction drain is effective in preventing early wound complications after laparotomy for repair of duodenal ulcer perforation.