The effect of subcutaneous drain insertion after median sternotomy on surgical site infection in obese patients

Abstract

Background: Sternal wound infection after cardiac surgery is associated with high morbidity and mortality. This study aimed to assess the effect of subcutaneous wound drainage on surgical site infection in overweight patients undergoing cardiac surgery via median sternotomy.

Methods: This prospective study was conducted on 100 obese patients undergoing sternotomy as a part of cardiac surgery from March 2021 to June 2022. The study included two groups. Group 1 (n= 45) had prophylactic subcutaneous drainage after surgery, and Group 2 (n= 55) did not have prophylactic subcutaneous drainage.

Results: Hospital stay (7.8±1.9 vs. 8.65±1.38 days; P= 0.013) were higher in patients without drains. Deep sternal wound infection [2 (4.44%) vs. 9 (16.4%); P= 0.105], superficial wound infection [2 (4.44%) vs. 7 (12.7%); P= 0.18] and debridement with secondary suture [1 (2.2%) vs. 6 (10.9%); P= 0.125] were non-significantly lower in patients with subcutaneous drains.

Conclusion: Obese cases who received prophylactic subcutaneous wound drainage after sternotomy wound closure could have a lower incidence of wound complications. A larger randomized trial is recommended.