Using a Full-depth Wound Drainage System to Decrease Wound Infection Rates in the Morbidly Obese

The morbidly obese surgical patient is at increased risk for wound complications due to mechanical stresses from a deep and heavy subcutaneous tissue layer that create dead spaces in which hematomas and seromas can form. To drain the full depth of this layer, we revised an existing wound drainage system using cut segments of a Davol drain and added a Velcro binder to minimize lateral stress on the wound. We used the full-depth drain for all 384 morbidly obese patients who underwent vertical banded gastroplasty during a 10-year period. No patient developed a wound infection in the hospital; however, three patients had wound abscesses one month postoperatively, an infection rate of 0.78%. We believe that the drain system was an important factor in producing the low infection rate.