The association of surgical drains with surgical site infections - A prospective observational study.

Background: Surgical drains are widely used despite limited evidence in their favor. This study describes the associations between drains and surgical site infections (SSI).
Methods: This prospective observational double center study was performed in Switzerland between February 2013 and August 2015.
Results: The odds of SSI in the presence of drains were increased in general (OR 2.41, 95%CI 1.32-4.30, p = 0.004), but less in vascular and not in orthopedic trauma surgery. In addition to the surgical division, the association between drains and SSI depended significantly on the duration of surgery (p = 0.01) and wound class (p = 0.034). Furthermore, the duration of drainage (OR 1.24, 95%CI 1.15-1.35, p < 0.001), the number (OR 1.74, 95%CI 1.09-2.74, p = 0.019) and type of drains (open versus closed: OR 3.68, 95%CI 1.88, 6.89, p < 0.001) as well as their location (overall p = 0.002) were significantly associated with SSI.
Conclusions: The general use of drains is discouraged. However, drains may be beneficial in specific surgical procedures.
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