A Comparative Study on the Effectiveness of Placing Subcutaneous Suction Drains in Emergency Midline Laparotomy Incisions

BackgroundSurgical site infection (SSI) is a common complication following emergency midline laparotomy and is associated with increased morbidity, prolonged hospitalisation, and higher healthcare costs.Subcutaneous suction drainage has been proposed as an adjunct to postoperative wound management by facilitating fluid removal from the subcutaneous space.This study aimed to compare SSI incidence, postoperative wound findings, and length of hospital stay between patients undergoing emergency midline laparotomy with and without subcutaneous suction drainage. MethodsThis prospective comparative study was conducted in the Department of General Surgery at Kempegowda Institute of Medical Sciences, Bengaluru, over 18 months.A total of 60 consecutive adult patients undergoing emergency midline laparotomy were included, with 30 patients in the subcutaneous suction drain group (Group A) and 30 in the no-drain group (Group B).Group allocation was nonrandomised and based on the treating surgical team's clinical decision.Postoperative wound findings, including pain, redness, discharge, seroma formation, and wound dehiscence, were assessed on postoperative days 2, 3, 5, 7, 15, and 29.SSI incidence was compared using Fisher's exact test.Continuous outcomes were analysed using appropriate statistical tests, and multiple day-specific comparisons of wound findings were adjusted using the Holm procedure. ResultsThe overall incidence of SSI was 26.7% (8/30) in Group A and 50.0%(15/30) in Group B; however, the difference was not statistically significant (p = 0.110).Wound-related findings were generally less frequent in the drain group at several follow-up assessments, but none of the day-specific comparisons remained statistically significant after Holm correction.The mean length of hospital stay was significantly shorter in Group A than in Group B (10.13 ± 3.22 vs. 12.00 ± 3.07 days; mean difference, -1.87 days; 95% CI, -3.49 to -0.25; p = 0.025). ConclusionsSubcutaneous suction drainage was associated with a shorter hospital stay and a lower observed incidence of SSI following emergency midline laparotomy.However, the difference in SSI incidence was not statistically significant, and the day-specific wound-related findings were not statistically significant after adjustment for multiple comparisons.Larger multicentre studies are needed to clarify the effectiveness of subcutaneous suction drainage in preventing postoperative wound complications and to identify patients most likely to benefit.