T-tube suction drainage and/or prophylactic antibiotics. A randomized study of 451 hysterectomies

The technics of T-tube suction drainage of the retroperitoneal space and of prophylactic antibiotics were evaluated each alone and then in combination in a randomized study of 451 private patients undergoing abdominal or vaginal hysterectomy. As compared with results in a control group, suction drainage alone and prophylactic antibiotics alone were equally effective in reducing the incidence of postoperative pelvic infection and febrile morbidity. When the two technics were used in combination, there was further reduction in the incidence of pelvic infection and febrile morbidity. However, these results were not statistically different from those of either technic alone. Date are presented to indicate that hysterectomy is performed in a bacteriologically contaminated operative field and that a contaminated fluid collection routinely accumulates in the retroperitoneal space. It is therefore suggested that hysterectomy be managed as a potentially infected surgical wound.