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J Gastrointest Surg. 2017 Dec;21(12):2083-2089. doi: 10.1007/s11605-017-3601-0. Epub 2017 Oct 5.

Drain Placement Does Not Increase Infectious Complications After Retromuscular Ventral Hernia Repair with Synthetic Mesh: an AHSQC Analysis.

Author information

1
Comprehensive Hernia Center, Digestive Disease and Surgical Institute, The Cleveland Clinic Foundation, 9500 Euclid Avenue, A-100, Cleveland, OH, 44195, USA. krpatad@ccf.org.
2
Comprehensive Hernia Center, Digestive Disease and Surgical Institute, The Cleveland Clinic Foundation, 9500 Euclid Avenue, A-100, Cleveland, OH, 44195, USA.
3
Department of Surgery, Greenville Health Systems, Greenville, SC, USA.
4
Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, 37212, USA.
5
Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, 37212, USA.

Abstract

BACKGROUND:

The use of surgical drains after ventral hernia repair (VHR) remains controversial. Some have concerns of increased infectious complications; others advocate that drains reduce fluid accumulation and surgical site occurrences (SSO). The aim of our study was to investigate the impact of retromuscular drains on SSO following retromuscular VHR with synthetic mesh.

METHODS:

Utilizing the Americas Hernia Society Quality Collaborative, patients between January 2013 and January 2016 undergoing retromuscular VHR with synthetic mesh were assessed for the presence of a drain. Propensity score matched patients (2 drains: 1 no drain) were evaluated for 30-day rates of SSO, surgical site infections (SSI) and SSO requiring procedural intervention (SSOPI).

RESULTS:

Five hundred eighty-one patients were identified as having undergone open, retromuscular VHR with synthetic mesh. Four hundred eighty-one patients with drains and 100 without drains. After matching, 300 patients were compared, 200 with drain placement and 100 without. Retromuscular drains were less likely to develop a noninfectious SSO (OR, 0.33). Drain placement was not associated with SSI (OR, 1.30) or SSOPI (OR, 0.94).

CONCLUSION:

Drain placement after retromuscular VHR with synthetic mesh is a common practice. Based on an analysis of early outcomes, surgical drains do not increase the risk of surgical infectious complications, and may be protective against some SSOs, such as seroma formation.

KEYWORDS:

Closed suction drain; Surgical drain; Surgical site infection; Surgical site occurrence; Ventral hernia repair

PMID:
28983795
DOI:
10.1007/s11605-017-3601-0
[Indexed for MEDLINE]

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