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Abdominal Drainage in Complicated Appendicectomy - Resources Down the Drain?

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Using drains in complicated appendicitis surgery did not prevent complications and increased hospital stay. This study suggests avoiding drains to reduce post-operative complications and length of stay in appendicectomy patients.

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Area of Science:

  • Surgical outcomes
  • Abdominal surgery

Background:

  • Consensus is lacking on the utility of surgical drains in appendicectomy to prevent abscess formation.
  • Complicated appendicitis requires careful management to minimize post-operative morbidity.

Purpose of the Study:

  • To determine if intra-operative drains reduce post-operative complications and length of stay in patients with complicated appendicitis.
  • To evaluate the impact of drains on abscess formation following appendicectomy.

Main Methods:

  • Retrospective review of 76 patients with complicated appendicitis (perforated or gangrenous) from March-November 2018.
  • Patients were divided into two groups: Group 1 (with drain) and Group 2 (no drain).
  • Comparison of post-operative complications, intra-abdominal abscess rates, and length of stay between the two groups.

Main Results:

  • Patients with drains (Group 1) had significantly higher pre-operative CRP levels (124.8 vs. 48.3, p=0.02).
  • Post-operative complications (34.6% vs. 12%, p=0.019) and length of stay (5.5 days vs. 3 days, p=0.0001) were significantly higher in the drain group.
  • Intra-abdominal abscess rates showed a trend towards being higher in the drain group (19.2% vs. 6%, p=0.07).

Conclusions:

  • Intra-operative drain use in complicated appendicitis is associated with increased post-operative complications.
  • The use of drains in this patient population significantly increases length of hospital stay.
  • Findings suggest that drains may not be beneficial and could be detrimental in complicated appendicitis cases.