Publication:

A comparative study of laparotomy closure in peritonitis with and without intraabdominal drainage

Background Purpose of this study was to investigate whether the use of abdominal drainage after laparotomy for peritonitis can prevent or significantly reduce post-operative complications such as intra-peritoneal abscess formation or wound infection.

Methods A prospective randomized study was done of one hundred and one (101) cases who underwent emergency laparotomy at General Hospital Palanpur and Sushrut Surgical Hospital, Palanpur. After completion of operation for peritonitis peritoneal cavity was either drained or not drained. Drained group of cases was termed as group A and non-drained group of cases was termed as group B. Parameters noted in group A were daily drain output, character and culture sensitivity of the fluid. Surgical outcomes in form of hospital stay and postoperative complications like wound infection, wound dehiscence, residual abscess within month of operation were compared between two groups.

Results Significant difference was observed between drained group and non-drained groups in terms of length of hospital stay, wound infection, wound dehiscence, residual abscess and overall postoperative complicationConclusions: From the present study we deduce that prophylactic abdominal drain in each case is unnecessary, as it stops functioning latest by 72 hours if not draining. On the contrary it invites infection from outside. This may delay convalescence. Drain should be kept when leak from suture line is anticipated or when there is lot of necrotic tissue within peritoneal cavity, and kept till it functions; otherwise it should be removed earliest.