DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20174031

A clinical study to compare drain versus no drain in post cesarean section

Jyoti Bindal, Geetanjali Munda

Abstract


Background: Cesarean section is one of the commonest hospital based surgical procedure in obstetric mainly done to facilitate delivery in case where vaginal delivery is either not feasible or poses undue risk to mother, baby or both. The most common complications of CS are superficial surgical site complications including sepsis, seroma formation and breakdown.

Methods: A prospective study done on 100 patients admitted in labour room of Department of Obstetrics and Gynaecology, Kamla Raja Hospital, G.R.M.C., Gwalior between November 2015 to March 2016. Study divided into two groups: group I, including women who had no subcutaneous drain left and group II, including women who had a subcutaneous drain left before closure of the skin; Each group has 50 patients. The study included term pregnant women with pre-operative Hb >9 gm%, BMI >30 kg/m2 and were taken for emergency cesarean sections (for cephaloppelvic disproportion, fetal distress, abnormal presentations) with no intraoperative complications (hemorrhage, blood transfusion).

Results: VAS median grade in patients without drain was G3 (46%), followed by G2 (28%), G4 (14%). VAS median grade in with drain group was G2 (68%), followed by G1 (24%) and then G3 (08%). Wound infection was noted in 4 (08%) patients in both the groups. Both groups were administered same group of intravenous antibiotics for 5 days. The mean hospital stay in patients without drain were 9.4 days and patients with drain were 8.2 days. The mean haemoglobin in patient with drain was 8.6 gm% and patients without drain was 9.4 gm%. Wound seroma in 13 cases and superficial breakdown in 4 cases in non-drain group versus 5 cases and 2 cases in drain group respectively. There is significant difference in postoperative pain and non-significant difference in postoperative fever.

Conclusions: Patients in with drain group have reduced rates of wound seroma, postoperative pain, shorter hospital stay, but there is insignificant benefit regarding post-operative fever, superficial SSI, wound breakdown and hemoglobin concentration.


Keywords


Cesarean section, Drain, VAS

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