Meta-Analysis
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Dec 27, 2023; 15(12): 2879-2889
Published online Dec 27, 2023. doi: 10.4240/wjgs.v15.i12.2879
Recent evidence for subcutaneous drains to prevent surgical site infections after abdominal surgery: A systematic review and meta-analysis
Tomohiro Ishinuki, Hiroji Shinkawa, Keita Kouzu, Seiichi Shinji, Erika Goda, Toshio Ohyanagi, Masahiro Kobayashi, Motomu Kobayashi, Katsunori Suzuki, Yuichi Kitagawa, Chizuru Yamashita, Yasuhiko Mohri, Junzo Shimizu, Motoi Uchino, Seiji Haji, Masahiro Yoshida, Hiroki Ohge, Toshihiko Mayumi, Toru Mizuguchi
Tomohiro Ishinuki, Toru Mizuguchi, Department of Nursing, Surgical Sciences, Sapporo Medical University, Sapporo 060-8556, Hokkaido, Japan
Hiroji Shinkawa, Department of Hepatobiliary-Pancreatic Surgery, Osaka Metropolitan University Graduate School of Medicine, Abeno-Ku 545-0051, Japan
Keita Kouzu, Department of Surgery, National Defense Medical College, Tokorozawa 359-8513, Japan
Seiichi Shinji, Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo 113-8602, Japan
Erika Goda, Department of Nursing, Japan Health Care University, Sapporo 062-0053, Japan
Toshio Ohyanagi, Department of Liberal Arts and Sciences, Center for Medical Education, Sapporo Medical University, Sapporo 060-8556, Japan
Masahiro Kobayashi, Department of Clinical Pharmacokinetics, Research and Education Center for Clinical Pharmacy, Kitasato University, Tokyo 108-8641, Japan
Motomu Kobayashi, Department of Anesthesiology, Hokushinkai Megumino Hospital, Eniwa 061-1395, Japan
Katsunori Suzuki, Department of Infectious Disease Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan
Yuichi Kitagawa, Department of Gastrointestinal Surgery, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
Chizuru Yamashita, Department of Anesthesiology and Critical Care Medicine, Fujita Health University, Toyoake 470-1192, Japan
Yasuhiko Mohri, Department of Gastrointestinal Surgery, Mie Prefectural General Medical Center, Yokkaich 510-8561, Japan
Junzo Shimizu, Department of Surgery, Toyonaka Municipal Hospital, Toyonaka 560-8565, Japan
Motoi Uchino, Department of Gastroenterological Surgery, Hyogo Medical University, Nishinomiya 663-8501, Japan
Seiji Haji, Department of Surgery, Soseikai General Hospital, Kyoto 612-8473, Japan
Masahiro Yoshida, Department of Hepato-Biliary-Pancreatic & Gastrointestinal Surgery, International University of Health and Welfare, Ichikawa 272-0827, Japan
Hiroki Ohge, Department of Infectious Disease, Hiroshima University Hospital, Hiroshima 734-8551, Japan
Toshihiko Mayumi, Department of Intensive Care Unit, Chukyo Hospital, Japan Community Health Care Organization, Nagoya 457-8510, Japan
Author contributions: Ishinuki T conducted the acquisition of data, abstract evaluation, full-text evaluation, interpretation of data, result discussion, and drafting the article; Shinkawa H conducted the acquisition of data, interpretation of data, and drafting the article; Kouzu K conducted the acquisition of data, abstract evaluation, and result discussion; Shinji S conducted the acquisition of data bias evaluation; Goda E conducted the full-text evaluation and graphic design; Ohyanagi T conducted statistical analyses and graphic design; Kobayashi Ma conducted the acquisition of data and bias evaluation; Kobayashi Mo conducted the abstract evaluation and bias evaluation; Suzuki K conducted the abstract evaluation and interpretation of data; Kitagawa Y conducted the full-text evaluation and bias evaluation; Yamashita C conducted the abstract evaluation and bias evaluation; Mohri Y conducted the full-text evaluation and bias evaluation; Shimizu J conducted the abstract evaluation and bias evaluation; Uchino M conducted the full-text evaluation and graphic design; Haji S conducted the full-text evaluation; Yoshida M conducted the interpretation of data and statistical analyses; Ohge H conducted result discussion; Mayumi T conducted a design of the review and result discussion; Mizuguchi T conducted conception of the review and result discussion.
Supported by Grants-in-Aid from JSPS KAKENHI, No. JP 21K10715 and No. JP 20K10404; Northern Advancement Center for Science & Technology, No. T-2-2; the Yasuda Medical Foundation, No. 31010316; the Okawa Foundation for Information and Telecommunications, No. 41111042; Taiju Life Social Welfare Foundation, No. 50811490; Japan Keirin Autorace Foundation, No. 2023M-378; Project Mirai Cancer Research Grants, No. 31010269; Takahashi Industrial and Economic Research Foundation, No. 50411278; Sapporo Doto Hospital, No. 50311211; Noguchi Hospital, No. 40310551; Doki-kai Tomakomai Hospital, No. 40710739; and Tsuchida Hospital, No. 50811478.
Conflict-of-interest statement: All authors have nothing to disclose.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Toru Mizuguchi, MD, PhD, Doctor, Professor, Surgical Oncologist, Department of Nursing, Surgical Sciences, Sapporo Medical University, S1, W17, Chuo-Ku, Sapporo 060-8556, Hokkaido, Japan. tmizu@sapmed.ac.jp
Received: July 26, 2023
Peer-review started: July 26, 2023
First decision: October 9, 2023
Revised: October 23, 2023
Accepted: November 27, 2023
Article in press: November 27, 2023
Published online: December 27, 2023
Processing time: 154 Days and 11.5 Hours
Core Tip

Core Tip: This review supports the beneficial effects of subcutaneous drains after abdominal surgery. Subcutaneous drains may not prevent seroma formation. Most studies removed drains within 3 d regardless of the amount of fluid discharge. The timing of drain removal may affect the clinical outcome. Nevertheless, subcutaneous drains can prevent surgical site infections and shorten the length of hospital stays after abdominal surgery.