The role of drains in modern surgery

The role of drains in modern surgery

The routine use of surgical drains has generated much contro - versy . Protagonists suggest that the use of drains may: /uni25CF help remove the collection of purulent material, blood, serous fluid, bile, chyle, pancreatic or intestinal secretions; /uni25CF act as a signal for postoperative haemorrhage or anasto - motic leakages /uni25CF provide a track for long-term drainage. However, detractors claim that the presence of a drain may: /uni25CF increase intra-abdominal and wound infections by intro - ducing skin bacteria into the peritoneal cavity; /uni25CF delay recovery and increase hospital stay; /uni25CF increase abdominal pain; /uni25CF decrease pulmonary function; /uni25CF falsely reassure the clinician that there is no intra- abdominal collection, when in fact the drain is blocked. In reality , the use of drains depends on the surgeon’s indi - vidual preference and surgical philosophy . However, there is reasonable consensus regarding the role of drains in certain surgical procedures, as elucidated in Summary boxes 7.10 and 7.11 . Summary box 7.10 Current role of drain placement in non-gastrointestinal surgery /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF

Avoid routine drain placement Thyroid surgery Breast lumpectomy Inguinal hernia repair Consider routine drain placement Radical and modi /f_i ed radical neck dissection Parotid surgery Axillary dissection with or without mastectomy Inguinal lymphadenectomy Ventral hernia repair in obese patients

Current role of drain placement in gastrointestinal surgery /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF

Avoid routine drain placement following Colonic surgery Small bowel resections Hepatic resections Cholecystectomy Consider routine drain placement following Oesophageal surgery Major pancreatic resection Selective use of drains following Rectal surgery Gastric resections

The role of drains in modern surgery

The routine use of surgical drains has generated much contro - versy . Protagonists suggest that the use of drains may: /uni25CF help remove the collection of purulent material, blood, serous fluid, bile, chyle, pancreatic or intestinal secretions; /uni25CF act as a signal for postoperative haemorrhage or anasto - motic leakages /uni25CF provide a track for long-term drainage. However, detractors claim that the presence of a drain may: /uni25CF increase intra-abdominal and wound infections by intro - ducing skin bacteria into the peritoneal cavity; /uni25CF delay recovery and increase hospital stay; /uni25CF increase abdominal pain; /uni25CF decrease pulmonary function; /uni25CF falsely reassure the clinician that there is no intra- abdominal collection, when in fact the drain is blocked. In reality , the use of drains depends on the surgeon’s indi - vidual preference and surgical philosophy . However, there is reasonable consensus regarding the role of drains in certain surgical procedures, as elucidated in Summary boxes 7.10 and 7.11 . Summary box 7.10 Current role of drain placement in non-gastrointestinal surgery /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF

Avoid routine drain placement Thyroid surgery Breast lumpectomy Inguinal hernia repair Consider routine drain placement Radical and modi /f_i ed radical neck dissection Parotid surgery Axillary dissection with or without mastectomy Inguinal lymphadenectomy Ventral hernia repair in obese patients

Current role of drain placement in gastrointestinal surgery /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF

Avoid routine drain placement following Colonic surgery Small bowel resections Hepatic resections Cholecystectomy Consider routine drain placement following Oesophageal surgery Major pancreatic resection Selective use of drains following Rectal surgery Gastric resections

The role of drains in modern surgery

The routine use of surgical drains has generated much contro - versy . Protagonists suggest that the use of drains may: /uni25CF help remove the collection of purulent material, blood, serous fluid, bile, chyle, pancreatic or intestinal secretions; /uni25CF act as a signal for postoperative haemorrhage or anasto - motic leakages /uni25CF provide a track for long-term drainage. However, detractors claim that the presence of a drain may: /uni25CF increase intra-abdominal and wound infections by intro - ducing skin bacteria into the peritoneal cavity; /uni25CF delay recovery and increase hospital stay; /uni25CF increase abdominal pain; /uni25CF decrease pulmonary function; /uni25CF falsely reassure the clinician that there is no intra- abdominal collection, when in fact the drain is blocked. In reality , the use of drains depends on the surgeon’s indi - vidual preference and surgical philosophy . However, there is reasonable consensus regarding the role of drains in certain surgical procedures, as elucidated in Summary boxes 7.10 and 7.11 . Summary box 7.10 Current role of drain placement in non-gastrointestinal surgery /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF

Avoid routine drain placement Thyroid surgery Breast lumpectomy Inguinal hernia repair Consider routine drain placement Radical and modi /f_i ed radical neck dissection Parotid surgery Axillary dissection with or without mastectomy Inguinal lymphadenectomy Ventral hernia repair in obese patients

Current role of drain placement in gastrointestinal surgery /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF

Avoid routine drain placement following Colonic surgery Small bowel resections Hepatic resections Cholecystectomy Consider routine drain placement following Oesophageal surgery Major pancreatic resection Selective use of drains following Rectal surgery Gastric resections