"Doesn't require subcutaneous drainage tube insertion during gynecological disease laparotomy"
Aug 15, 2024
Studies have shown that inserting a subcutaneous drainage tube in an abdominal incision caused by a gynecological disease is not related to a significant improvement in wound opening or infection incidence.
This is the research result of Kim Ki-dong, a professor of obstetrics and gynecology at Bundang Seoul National University Hospital, and Kim Nam-kyung, a professor of obstetrics and gynecology at.
Despite the advancement of minimally invasive surgery, abdominal incision is recommended as the standard approach in the area of gynecological gynecologic cancer (such as ovarian cancer, cervical cancer, etc.). However, in gynecological diseases, post-optic wound complications occur in approximately 8% to 37% of patients, which degrades the patient's quality of life and incurs additional treatment costs. In particular, complications arising from malignant tumor patients can delay postoperative treatment, so it is most important to prevent wound complications.
One of the risk factors for increasing wound complications is hematoma, gas, and various exudates at the surgical incision site. Therefore, when the wound of the abdomen is sutured after laparotomy, a subcutaneous drainage tube is inserted and removed from the body. However, since subcutaneous drainage tube insertion can cause bleeding and has the disadvantage of being cumbersome to manage, studies on the effect of drainage tube insertion on wound opening and infection incidence have been required. To date, studies evaluating the effectiveness of subcutaneous drainage tubes have been conducted in obese patients or patients undergoing cesarean section, and inconsistent results have been reported. There are no studies confirming the effect of subcutaneous drainage tube insertion on wound opening or wound infection in laparotomy performed due to gynecological disease.
Accordingly, the research team of professors Kim Ki-dong and Kim Nam-kyung excluded patients with high BMI from clinical trials because they underwent laparotomy for gynecological diseases at nine institutions in Korea from February 2021 to December 2021, and obesity with a body mass index (BMI) of less than 35kg/m2 is one of the risk factors for increasing wound infections and wound opening, and pathological obesity can affect wound recovery due to other diseases besides obesity.
A non-blind, randomized clinical trial was conducted on 162 human patients.
The research team compared the incidence of wound opening at 4 weeks after surgery, cumulative wound opening up to 4 weeks after surgery, and cumulative infection rate of 79 patients (treatment group) and 83 patients (control group) in the subcutaneous drainage tube insertion group. Variables such as average operating time and average wound length were similar in the two groups.
As a result of the study, the incidence of wound opening (1.3% in the treatment group, 2.4% in the control group, p>0.999), the incidence of cumulative wound opening (8.9% in the treatment group, 6.0% in the control group, p=0.491), and the incidence of cumulative infection (1.3% in the treatment group, 0.0% in the control group, p=0.488) at 4 weeks after surgery were similar.
Professor Kim Ki-dong said, "Injecting a subcutaneous drainage tube into a patient undergoing laparotomy for gynecological diseases does not result in a significant improvement in the incidence of wounds and infections. Unless there are additional risk factors such as severe obesity or diseases that can affect wound recovery, there is no need to insert a subcutaneous drainage tube."
This is the research result of Kim Ki-dong, a professor of obstetrics and gynecology at Bundang Seoul National University Hospital, and Kim Nam-kyung, a professor of obstetrics and gynecology at.
Despite the advancement of minimally invasive surgery, abdominal incision is recommended as the standard approach in the area of gynecological gynecologic cancer (such as ovarian cancer, cervical cancer, etc.). However, in gynecological diseases, post-optic wound complications occur in approximately 8% to 37% of patients, which degrades the patient's quality of life and incurs additional treatment costs. In particular, complications arising from malignant tumor patients can delay postoperative treatment, so it is most important to prevent wound complications.
One of the risk factors for increasing wound complications is hematoma, gas, and various exudates at the surgical incision site. Therefore, when the wound of the abdomen is sutured after laparotomy, a subcutaneous drainage tube is inserted and removed from the body. However, since subcutaneous drainage tube insertion can cause bleeding and has the disadvantage of being cumbersome to manage, studies on the effect of drainage tube insertion on wound opening and infection incidence have been required. To date, studies evaluating the effectiveness of subcutaneous drainage tubes have been conducted in obese patients or patients undergoing cesarean section, and inconsistent results have been reported. There are no studies confirming the effect of subcutaneous drainage tube insertion on wound opening or wound infection in laparotomy performed due to gynecological disease.
Accordingly, the research team of professors Kim Ki-dong and Kim Nam-kyung excluded patients with high BMI from clinical trials because they underwent laparotomy for gynecological diseases at nine institutions in Korea from February 2021 to December 2021, and obesity with a body mass index (BMI) of less than 35kg/m2 is one of the risk factors for increasing wound infections and wound opening, and pathological obesity can affect wound recovery due to other diseases besides obesity.
A non-blind, randomized clinical trial was conducted on 162 human patients.
The research team compared the incidence of wound opening at 4 weeks after surgery, cumulative wound opening up to 4 weeks after surgery, and cumulative infection rate of 79 patients (treatment group) and 83 patients (control group) in the subcutaneous drainage tube insertion group. Variables such as average operating time and average wound length were similar in the two groups.
As a result of the study, the incidence of wound opening (1.3% in the treatment group, 2.4% in the control group, p>0.999), the incidence of cumulative wound opening (8.9% in the treatment group, 6.0% in the control group, p=0.491), and the incidence of cumulative infection (1.3% in the treatment group, 0.0% in the control group, p=0.488) at 4 weeks after surgery were similar.
Professor Kim Ki-dong said, "Injecting a subcutaneous drainage tube into a patient undergoing laparotomy for gynecological diseases does not result in a significant improvement in the incidence of wounds and infections. Unless there are additional risk factors such as severe obesity or diseases that can affect wound recovery, there is no need to insert a subcutaneous drainage tube."
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