DRAIN VERSUS NO DRAIN FOLLOWING ELECTIVE ABDOMINAL SURGERY: A COMPARATIVE ANALYSIS OF POSTOPERATIVE COMPLICATIONS

Abstract

Background: The routine use of surgical drains following elective abdominal surgery remains controversial. While drains are traditionally employed to detect early complications and prevent fluid collection, their role in uncomplicated elective procedures has been increasingly questioned due to potential discomfort, infection risk, and prolonged hospital stay. Objective: To compare postoperative outcomes between patients undergoing elective abdominal surgery with routine drain placement and those without drains. Methods: This prospective comparative study was conducted in a tertiary care hospital over an 18-month period. A total of 56 patients undergoing elective abdominal surgery were included and divided into two groups: drain group [n = 28] and no-drain group [n = 28]. Postoperative outcomes assessed included surgical site infection, seroma or collection, postoperative pain scores, time to ambulation, and length of hospital stay. Statistical analysis was performed using appropriate parametric and non-parametric tests, with a p value <0.05 considered significant. Results: The incidence of surgical site infection was comparable between the drain and no-drain groups [14.3% vs 10.7%]. Seroma formation occurred in 3 patients in the drain group and 2 patients in the no-drain group. Mean postoperative pain scores were higher in the drain group on postoperative day one [5.1 ± 0.9 vs 3.8 ± 0.8]. The mean hospital stay was significantly longer in patients with drains [6.2 ± 1.4 days] compared to those without drains [4.5 ± 1.2 days]. No significant difference was observed in major postoperative complications between the two groups. Conclusion: Routine drain placement following uncomplicated elective abdominal surgery does not confer a clear advantage in reducing postoperative complications and may be associated with increased pain and prolonged hospital stay. Selective rather than routine use of drains appears to be a more appropriate strategy.