CLOSED VERSUS OPEN PASSIVE DRAINS IN EMERGENCY ABDOMINAL SURGERIES

Abstract

Drains are used prophylacticaly in emergency abdominal surgeries for drainage of pus or collection left after peritoneal lavage given during the laparotomy procedure. Drains used in abdominal surgeries are of two types Active and Passive. Active drains are based on suction mechanism. Passive type drains are by means of difference in pressure and gravity. Passive drains are of two types- Closed and Open.  Closed drain is a simple sterile red rubber or polyvinyl chloride tube which is connected to outside container bag, i.e. closed on both the sides. While, open drain is a corrugated rubber or polyvinyl chloride not connected to bag but covered by sterile dressing outside. Closed drains are commonly used but they are blocked early and lead to collection of fluid in abdominal cavity. Purpose of our study was to compare these closed drains with open type having less problems of blockage.

Among the patients of clean contaminated wounds, moderate amount of  fluid collection was noted in ultrasound examination in pelvic cavity in 2 (11.1%) patients of Group A and 1(10%) patient of Group B. Surgical wound infection was more in patients of Group B (20%>11.1%). Signs of pelvic abscess found in one patient of Group A. In cases of contaminated and dirty wounds, ultrasound examination showed moderate amount of collection in 5 (13.8%) patients of Group A as compared to 1(5%) in Group B. Surgical wound infection was more in patients of Group B (25%>22.2%). Drain site infection was more in Group B (25%>8.33%). Signs of pelvic abscess found in 1 patient while high grade fever was found in 3 patients of Group A. On statistical analysis there was no significant difference in complications between the two drains except that of more drain site infection in open drain.