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A Prospective Analysis of the Association Between Indwelling Surgical Drains and Surgical Site Infection in Plastic Surgery

Reiffel, Alyssa J. MD*; Pharmer, Lindsay A. MD*; Weinstein, Andrew L. BS; Spector, Jason A. MD, FACS*

doi: 10.1097/SAP.0b013e31824c905b
Reconstructive Surgery
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Introduction Many surgeons fear that closed-suction drains serve as a portal for bacterial entry into surgical spaces. Despite a lack of supporting evidence, postoperative antibiotics are often prolonged while drains remain in place.

Methods Medical records of all patients who underwent intraoperative Jackson-Pratt drain placement and sterile removal over a 12-month period were prospectively analyzed.

Results Fifty-four patients with 101 drains were included. Drains were in place for 5 to 43 days [mean (SD), 13.5 (6.3) days]. Sixty-three percent of drains had positive cultures. All patients received perioperative antibiotics. Thirty-nine patients received postoperative antibiotics [mean (SD), 13.8 (13.8) days]. There were 2 cases of cellulitis. One patient required reoperation.

Conclusions Sixty-six drains (65.3%) were placed in the presence of prosthetic material. Although nearly two thirds of drains were colonized with bacteria, our wound infection rate was extremely low (5.6%). Thus, closed-suction drains may be left in place for an extended period without increasing the risk of infection, even in the presence of prosthetic material.

From the *Division of Plastic Surgery, Weill Cornell Medical College, New York, NY; and †School of Medicine, New York University, New York, NY.

Received September 10, 2011, and accepted for publication, after revision, January 23, 2012.

Conflicts of interest and sources of funding: A portion of this research was funded by a Ruth L. Kirschstein National Research Service Award Institutional Research Training Grant (T32 HL 083824 05).

Presented at the American Society of Plastic Surgeons 80th Annual Meeting, Denver, CO, and the Northeastern Society of Plastic Surgeons 28th Annual Meeting, Amelia Island, FL.

Reprints: Jason A. Spector, MD, FACS, Weill Cornell Medical College, Payson 709A, New York, NY 10065. E-mail: Jas2037@med.cornell.edu.

© 2013 by Lippincott Williams & Wilkins