Suction drainage as an alternative to prophylactic antibiotics for hysterectomy

A technic is described for suction drainage of the retroperitoneal space. Its use is evaluated in 150 private patients undergoing vaginal or abdominal hysterectomy and compared with 150 private control patients. This technic resulted in an average of 40 cc of fluid (range, 10-200 cc) being suctioned from the retroperitoneal space. With this technic febrile morbidity decreased from 26 to 11% for abdominal hysterectomies and from 32 to 8% for vaginal hysterectomies. Information is offered to explain the physiology of posthysterectomy infections, the effectiveness of prophylactic antibiotics, and the paradox of a febrile morbidity higher for vaginal than for abdominal hysterectomies. The risks in using prophylactic antibiotics routinely are stated, and suction drainage is suggested as a preferable alternative.