Characteristics of Subcutaneous Drainage Fluid in Patients After Hepatopancreatobiliary Surgery
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ORIGINAL ARTICLE
Characteristics of Subcutaneous Drainage Fluid in Patients After Hepatopancreatobiliary Surgery Lei Gong 1 & Bin Shu 1 & Xin Huang 1 & Xiaobin Feng 1 Received: 3 June 2019 / Accepted: 7 February 2020 # Association of Surgeons of India 2020
Abstract The beneficial effect of subcutaneous drainage has been challenged. Here, we evaluated subcutaneous drainage fluid characteristics in patients without complications after hepatopancreatobiliary surgery. We aimed to provide useful information for addressing this issue. We included 59 patients that underwent hepatopancreatobiliary surgery for hepatic (n = 33), biliary (n = 12), and pancreatic (n = 14) disorders. We recorded the total volume of drainage liquid. We analyzed drainage fluid characteristics (biochemical test, cells, etc.) and patient demographic and clinical characteristics. Differences in characteristics were assessed among hepatic, biliary, and pancreatic surgery groups. Pearson correlation coefficient analyses were performed to assess associations between preoperative parameters and drainage volume. The median body mass index was 24.01 kg/m2. The mean blood loss and operation time were 371 ml and 406 min, respectively. Three (5.1%) patients required transfusions. The median drainage fluid volume was 37.34 ml, and the median density was 1.0217. The total numbers of white and red blood cells were 4.38*105/L and 30.5*103/L, respectively. The protein, glucose, and adenosine deaminase contents were 34.41 g/L, 1.22 mmol/L, and 103.09 U/L, respectively. The Rivalta test and lactate dehydrogenase were positive in 14 (77.8%) and 16 (88.9%) patients, respectively. All parameters were similar between the three surgical groups. Preoperative erythrocyte and hemoglobin levels were weakly positively correlated with subcutaneous drainage fluid volumes. We found a substantial amount of protein in subcutaneous drainage fluid. Removing the fluid might reduce the risks of incision fat liquefaction and infection. At minimum, subcutaneous drainage reduced the frequency of incisional dressing changes. Keywords Subcutaneous drainage . Content analysis . Hepatopancreatobiliary surgery . Surgical site infection . Fat liquefaction
Introduction Incision fat liquefaction and surgical site infections (SSIs) remain troublesome problems in surgical practices. The incidence of SSIs varies from 1.9 to 7.8% in different types of surgeries [1, 2]. It has been demonstrated that SSIs were associated with increased hospital stay times, morbidity, mortality, and medical costs. Great efforts have been taken to reduce the rate of SSIs. One of the most widely used methods of preventing SSIs is subcutaneous drainage. Surgeons worldwide believe that this method can prevent surgical wound complications, including * Lei Gong [email protected] 1
Center of Hepatopancreatobiliary Diseases, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No.168 Litang Road, Changping District, Beijing, China
fat liquefaction, seroma, hematoma, abscess, and infect
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