CORRELATION BETWEEN ASCENDING INFECTION AND SURGICAL DRAIN USE: A CROSS SECTIONAL STUDY

Abstract

Introduction: Drains are used as an integral tool in surgical practice, and have been used since the mid-1800s but, in recent years it is starting to be understood that the presence of a surgical drain and its prolonged use may be associated with an increased risk of infection. We aimed to identify whether drains could be considered an independent risk factor to ascending infections. Methods: The study aims to establish a correlation between ascending infection and the duration of drain usage. Thus, to minimise confounding variables that may lead to bacterial inoculation, this study only includes in situ drain tips from patients undergoing a clean surgery (with CDC class 1 wound) with a drain retained in situ for at least 72 hours. A positive culture is inferred as biolm formation, which is taken to be a precursor to ascending infection.(n=43). Findings: This study demonstrates an increasing trend of biolm formation within drains in situ with time. It ranges from 4.8-14.3% in patients who had drains in situ for 72 to 96 hours, to up to 28.6% after 96 hours. Even though an increasing trend is seen, the study could not prove that a statistically signicant correlation exists between the infection due to the post-op usage of a drain and the time it is left in situ (p=0.343), even with possible skin contaminants being considered as positive results (p=0.453). Conclusion: There seems to be an increasing trend of infection with time but, since the scope of this study was limited by its small sample size, replication studies with a larger sample size and randomized controlled trials or meta-analyses on the topic are still required to ascertain correlation and causality. Summary: We aimed at nding a correlation between the duration of drain placement and ascending infection towards the surgical site. The results of this study indicate that with a longer usage time, there is a rise in rates of biolm formation. The importance of this nding is that it points towards surgical drains as being one of the etiological factors of infection, but the same cannot be said conclusively and solely based on this study, and requires further investigation in the form of larger and more rigorous studies.