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Wound drains after incisional hernia repair

  1. Kurinchi Selvan Gurusamy1,*,
  2. Victoria B Allen2

Editorial Group: Cochrane Wounds Group

Published Online: 17 DEC 2013

Assessed as up-to-date: 28 NOV 2013

DOI: 10.1002/14651858.CD005570.pub4


How to Cite

Gurusamy KS, Allen VB. Wound drains after incisional hernia repair. Cochrane Database of Systematic Reviews 2013, Issue 12. Art. No.: CD005570. DOI: 10.1002/14651858.CD005570.pub4.

Author Information

  1. 1

    Royal Free Campus, UCL Medical School, Department of Surgery, London, UK

  2. 2

    Oxford University Hospitals NHS Trust, Oxford University Clinical Academic Graduate School, Oxford, UK

*Kurinchi Selvan Gurusamy, Department of Surgery, Royal Free Campus, UCL Medical School, Royal Free Hospital,, Rowland Hill Street, London, NW3 2PF, UK. kurinchi2k@hotmail.com.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 17 DEC 2013

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Characteristics of included studies [ordered by study ID]
Shafik 1993

MethodsRandomised clinical trial (parallel study design)


ParticipantsCountry: Egypt.
Number randomised: 24.
Mean age: 48 years.
Females: 0 (0%).
Patients with incisional hernia following stoma closure.


InterventionsParticipants were randomly assigned to two groups.
Group 1: Electrified drain (n = 12).
Group 2: Corrugated drain (n = 12).

Co-interventions: all patients had a three day course of antibiotics post-operatively.
All were tissue repairs.


Outcomes1. Infection (>10,000 organisms per ml in culture of swab from drain site).
2. Clinical infection (redness, oedema and purulent discharge).
3. Need for additional course of antibiotics.


NotesContacted author to obtain information regarding allocation sequence, allocation concealment, blinding and hospital stay.


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Low riskQuote: "Random number table" (author replies).

Allocation concealment (selection bias)Unclear riskComment: This information could not be obtained.

Blinding of participants and personnel (performance bias)
All outcomes
High riskQuote: "Participants and outcome assessors were blinded by use of dummy electrodes".

Comment: The surgeons were not blinded to the groups.

Blinding of outcome assessment (detection bias)
All outcomes
Low riskQuote: "Participants and outcome assessors were blinded by use of dummy electrodes".

Comment: Since the participants or the outcome assessors could not determine whether the drain was electrified, they were adequately blinded.

Incomplete outcome data (attrition bias)
All outcomes
Low riskComment: There were no drop-outs or withdrawals after randomisation (author replies).

Selective reporting (reporting bias)Low riskComment: Important primary outcome namely wound infection was reported.

No bias due to source of funding?Unclear riskComment: The source of funding was not stated.

 
Characteristics of ongoing studies [ordered by study ID]
NCT00478348

Trial name or titleShould Prosthetic Repair of Incisional Abdominal Hernias be Drain or Not?

MethodsPrevention, Randomized, Open Label, Active Control, Parallel Assignment, Safety/Efficacy Study

ParticipantsInclusion Criteria:

  1. Clinical diagnosis of midline abdominal wall incisional hernia
  2. Adults of 20 to 80 years old
  3. ASA I to III
  4. Inform consent signed by the patient and investigators


Exclusion Criteria:

  1. Incisional hernia less than 2 cm
  2. Groin hernia
  3. Antibiotic treatment before and during hospital admission
  4. Emergency admission for strangulated incisional hernia
  5. Immunosuppressing treatment

InterventionsInsertion of three drains (Redon)

OutcomesEvidence of early clinical infection, hematoma, seroma or recurrence confirmed by ultrasonography or/and laboratory findings at 30 days

Starting dateMay 2007

Contact informationAlexandre Paroz, MD
Department of Visceral Surgery, University Hospital Center, Lausanne, Vaud, 1011
telephone: +41 21 314 52 34
alexandre.paroz@chuv.ch

Notes

 
Comparison 1. Electrified drain vs corrugated drain

Outcome or subgroup titleNo. of studiesNo. of participantsStatistical methodEffect size

 1 Clinical infection (redness, oedema, purulent discharge)124Risk Ratio (M-H, Fixed, 95% CI)0.2 [0.01, 3.77]