Comparison of Drains Versus No Drains in Abdominal Surgery: Impact on Morbidity and Recovery

Abstract

Background: The use of prophylactic drains in abdominal surgery remains controversial. Although drains are traditionally placed to prevent postoperative fluid collection and infection, recent evidence questions their routine benefit. This study aimed to compare postoperative morbidity and recovery between patients undergoing abdominal surgery with and without drains.

Methods: A prospective comparative study was conducted among 200 patients undergoing elective or emergency abdominal surgeries at a tertiary care center. Patients were divided into two groups: Drain group (n=100) and No-drain group (n=100). Postoperative morbidity parameters such as surgical site infection (SSI), seroma, wound dehiscence, and intra-abdominal collections were assessed. Recovery outcomes included postoperative pain, time to mobilization, return of bowel function, and hospital stay. Data were analyzed using Chi-square and Welch’s t tests; p<0.05 was considered statistically significant.

Results: Composite morbidity was comparable between groups (47% vs 38%, p=0.198). However, SSI was significantly higher in the drain group (29% vs 17%, p=0.043). Mean postoperative pain score was greater among drain patients (5.8 ± 1.7 vs 4.9 ± 1.6, p=0.0002). Time to mobilization (18.7 ± 6.3 h vs 14.9 ± 5.8 h, p<0.0001), return of bowel function (33.8 ± 9.7 h vs 29.1 ± 8.9 h, p=0.0004), and hospital stay (6.4 ± 2.3 vs 5.1 ± 1.9 days, p<0.0001) were all significantly prolonged in the drain group.

Conclusion: Routine drain placement after abdominal surgeries does not reduce morbidity and is associated with increased pain, delayed recovery, and higher infection rates. Drains should be used selectively based on intraoperative findings rather than as a standard practice.