Effect of Application of Subcutaneous Suction Drainage with Subcuticular Sutures for Wound Closure on the Incidence of Incisional Surgical Site Infection following Elective General Abdominal Surgery : A Randomized Controlled Trial

Abstract

Objective : The aim of this trial was to verify whether use of subcutaneous suction drainage with subcuticular sutures for wound closure might decrease the incidence of incisional surgical site infection (SSI) after general abdominal surgery.
Summary Background Data : The ideal method for wound closure following general abdominal surgery has not been established yet.
Methods : Patients were randomly assigned to receive either subcutaneous drainage with subcuticular sutures (drainage group) or subcutaneous sutures with skin stapling (control group). The primary end point was the incidence of incisional SSI within 30 days after surgery. This trial is registered with UMIN-CTR, number UMIN000003073.
Results : A total of 160 patients were randomly assigned to the drainage group (n＝81) or the control group (n＝79). Incisional SSI was observed in 12 patients (14.8%) in the drainage group, and 15 patients (19.2%) in the control group, with no significant difference between the two groups (P＝0.459). Subgroup analyses showed that the drainage method significantly reduced the incidence of SSIs in patients with diabetes mellitus (P＝0.048) and/or a subcutaneous fat pad thickness of ≥2.3cm (P＝0.043).
Conclusion : Application of the subcutaneous drainage with subcuticular suture method for wound closure was not associated with any significant decrease in the incidence of incisional SSIs as compared to that of the conventional method. However, the drainage method might be beneficial for reducing the risk of SSIs in patients with diabetes mellitus and/or a subcutaneous fat pad thickness of ≥2.3cm.