Year: 2026 | Month: October | Volume: 16 | Issue: 10 | Pages: 160-169
DOI: https://doi.org/10.52403/ijhsr.20261017
Efficacy of Subcutaneous Negative Pressure Suction Drain in Preventing Surgical Site Infections Following Emergency Exploratory Laparotomy: A Cross-Sectional Study from North East India
Antara Ray Bhaumik1, Kalpadip Deb2
1Senior Resident, Department of General Surgery, Agartala Government Medical College and G.B.P. Hospital, Agartala, Tripura, India.
2Medical Officer, Chhattisgarh State Power Company (CSPC), Chhattisgarh, India.
Corresponding Author: Dr. Antara Ray Bhaumik
ABSTRACT
Background: Surgical site infections (SSIs) are among the most common postoperative complications following emergency exploratory laparotomy, particularly in contaminated abdominal wounds. Subcutaneous negative pressure suction drains have been proposed to reduce dead space, evacuate exudates, and lower infection risk, but their efficacy remains uncertain in resource‑limited settings.
Objectives: To evaluate the effectiveness of subcutaneous negative pressure suction drains in preventing SSIs after emergency exploratory laparotomy and to identify key patient‑related risk factors influencing infection outcomes.
Methods: This prospective cross‑sectional study was conducted at Agartala Government Medical College and G.B.P. Hospital, Tripura, over 18 months. A total of 100 patients undergoing emergency laparotomy were enrolled and divided into two groups: 50 with subcutaneous drains and 50 without. Wound healing was assessed daily using the Southampton Grading System, and SSI diagnosis was confirmed by clinical and microbiological criteria. Statistical analysis was performed using Chi‑square and t‑tests, with p < 0.05 considered significant.
Results: Overall SSI incidence was 58%. Patients with drains had a lower infection rate (50%) than those without drains (66%), but the difference was not statistically significant (p = 0.156). Comorbidities, hypoalbuminemia, and elevated total leukocyte count were strongly associated with SSI occurrence (p < 0.005). All patients with comorbidities developed infection, while none with normal albumin levels developed SSI, compared with 27.6% among those without comorbidities. All patients with high TLC developed SSI (100%), whereas only 16% of those with low TLC experienced infection.
Conclusion: Subcutaneous negative pressure suction drains may modestly reduce SSI incidence in contaminated laparotomy wounds, but systemic risk factors such as comorbidities, nutritional status, and inflammatory markers exert a stronger influence. Comprehensive SSI prevention strategies should combine mechanical wound management with optimisation of patient physiology and nutrition, particularly in resource‑limited settings.
Key words: Emergency laparotomy, Surgical site infection, Negative pressure suction drain, Hypoalbuminemia, Comorbidities, Total leukocyte count, Southampton wound grading, Resource limited settings