Intervention Review

Wound drainage for caesarean section

  1. Simon Gates1,*,
  2. Elizabeth R Anderson2

Editorial Group: Cochrane Wounds Group

Published Online: 8 JUL 2009

Assessed as up-to-date: 2 AUG 2010

DOI: 10.1002/14651858.CD004549.pub2

Database Title

Additional Information

How to Cite

Gates S, Anderson ER. Wound drainage for caesarean section. Cochrane Database of Systematic Reviews 2005, Issue 1. Art. No.: CD004549. DOI: 10.1002/14651858.CD004549.pub2.

Author Information

  1. 1

    Warwick Medical School, University of Warwick, Warwick Clinical Trials Unit, Coventry, UK

  2. 2

    Royal Liverpool University Hospital, Department of Genito-urinary Medicine, Liverpool, UK

*Simon Gates, Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK. s.gates@warwick.ac.uk.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 8 JUL 2009

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary

Background

Subcutaneous and sub rectus sheath wound drains are sometimes used in women who have undergone caesarean section. The indications for using drains vary by clinician.

Objectives

To compare the effects of using a wound drain with not using a wound drain at caesarean section, and of different types of drain, on maternal health and healthcare resource use.

Search methods

For this update we searched the Cochrane Wounds Group Specialised Register (searched 3/8/10); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2010 Issue 3); Ovid MEDLINE - 1950 to July Week 3 2010; Ovid MEDLINE - In-Process & Other Non-Indexed Citations August 02, 2010; Ovid EMBASE - 1980 to 2010 Week 30; EBSCO CINAHL - 1982 to July 30 2010.

Selection criteria

Studies were included if they allocated women to groups at random and they compared any type of wound drain with no wound drainage, or with any other type of drain, in women undergoing caesarean section.

Data collection and analysis

Trials were evaluated for appropriateness for inclusion and methodological quality without consideration of their results. This was done by two reviewers according to pre-stated eligibility criteria.

Main results

Nine trials (2421 women) were included in the review. Meta-analysis found no evidence of a difference in the risk of wound infection, other wound complications, febrile morbidity or endometritis in women who had wound drains compared with those who did not. There was some evidence from one trial that a subcutaneous drain may increase wound infection compared to a sub-sheath drain (RR 5.42, 95% CI 1.28 to 22.98). No differences in outcomes were found between subcutaneous drainage and subcutaneous suturing in the three trials that made this comparison.

Authors' conclusions

At present there is no evidence that the routine use of wound drains at caesarean section confers any benefit to the women involved. However, neither moderate benefit nor harm are excluded. These trials do not answer the question of whether wound drainage is of benefit when haemostasis is not felt to be adequate. Further large trials comparing drainage with no drain are justified.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary

Use of wound drains after caesarean section

Women who have a caesarean section operation (removing the baby by surgery through the mother's abdomen) sometimes have a wound drain put in place. The review did not find any differences in the risk of wound infection or other post operative complications between women who had wound drains compared with those who did not, but the evidence is not conclusive.

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