Subcutaneous Suction Drain to Reduce Surgical Site Infection in Contaminated Cases of Emergency Laparotomy: A Randomized Controlled Trial

Abstract

Objective: To compare the frequency of surgical site infections (SSIs) in contaminated emergency laparotomy cases between two groups: with and without subcutaneous suction drains.

Methodology: This randomized controlled trial was conducted from December 2024 to February 2025 at the Department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad. A total of 150 patients aged 18 to 75 years who underwent midline exploratory laparotomy with contamination were included. Patients were randomly assigned to either the subcutaneous suction drain group (n = 75) or the control group without drains (n = 75). Data on demographic characteristics, comorbidities (diabetes mellitus and hypertension), and surgical site infections were collected. Surgical site infections were assessed using standard clinical criteria, including redness, swelling, pain, warmth, and wound discharge.
Results: The incidence of surgical site infections was significantly lower in the subcutaneous suction drain group (13.3%) compared to the control group (46.7%) (p < 0.001). Stratified analyses revealed that age, gender, comorbidities, and body mass index (BMI) were significant predictors of SSI risk. Among patients in the control group, younger patients (<40 years) had an infection rate of 44.1%, whereas older patients (>40 years) had an infection rate of 48.8% (p = 0.015).

Conclusion: The use of subcutaneous suction drains significantly reduces the incidence of surgical site infections in contaminated emergency laparotomy cases.