Role of subcutaneous drains in obese patients undergoing elective cholecystectomy: a cohort study.

Background: Prophylactic drainage of wounds is aimed to reduce the wound complications and thereby morbidity. Obese patients are at more risk. The objective of the present study was to determine whether subcutaneous drainage can reduce such complications in elective abdominal surgery (cholecystectomy) in obese patients.

Design: Randomized, prospective and comparative study.

Methods: Two hundred and fifty obese patients with body mass index (BMI) >32 and subcutaneous fat thickness of >3 cm undergoing elective Cholecystectomy were allocated into two groups, viz. study (n=125) and control (n=125). Incision technique was standardized for all the patients. Patients with sepsis, spillage and comorbid conditions were excluded from the study.

Results: Overall seroma formation occurred in 11 (8.80%) patients in the study group and 42 (33.60%) patients in the control group (p<0.05), the likelihood of seroma formation without drains was 6.5 times and 9.3 times more in patients with subcutaneous fat thickness of 3-3.9 cm and 4-5 cm, respectively. 71.43% of patients in the control group and 54.55% patients in the study group who developed seroma presented in the first week of surgery.

Conclusion: Prophylactic use of subcutaneous drains in obese patients undergoing cholecystectomy was found to reduce the seroma formation significantly.