Role of Closed Suction Drainage in Prevention of Surgical Site Infection in Intestinal Perforation

Abstract

Wound infection continues to represent a major problem, both in terms of how they affect the outcome of surgical procedure, and for their impact on length of hospital stay and cost of treatment. Despite, the amazing advances made by medical sciences, post-operative wound infection linger as a potential killer. Many methods have been evolved to combat wound infection over period of time. The surgical wound infection can be controlled by different measures, applied at pre-operative, intra operative and post-operative period. Advances in infection control practices include improved operating room ventilation, sterilization methods, barriers, surgical technique, and availability of antimicrobial prophylaxis. Despite these activities, SSI remains a substantial cause of morbidity and mortality among hospitalized patients. Closed suction drainage based on sub atmospheric pressure, has revolutionized the management of wounds. It improves the rate of angiogenesis, endothelial proliferation, the integrity of capillary blood flow, capillary calibre and decreasing oedema and the wounds. Closed suction drainage appears to be safe, effective and convenient to the patient and nursing staff and allows for less dressing change and quantification of wound to prevent post-operative infection. Closed suction drainage is a well-accepted method of drainage. The role in preventing post-operative seroma, hematoma, wound dehiscence and infection is well known. Thus, the use of surgical drains and tubes continues to be a common facet of post-operative management of surgical patients. Closed suction drainage of post-operative wound collection is a novel method of treating wound infection in intestinal perforation. The objective of closed suction drainage of surgical site (Incision) is to prevent infection in perforated intestine where contaminated peritoneum leads to surgical site infection invariably.

Keywords: Closed suction drain, Romovac, perforation