Impact of intra-abdominal drains in emergency gastrointestinal surgery: a scoping review

IntroductionIntra-abdominal drains are often placed in emergency gastrointestinal surgery procedures with the aim to prevent the formation of intra-abdominal collections (IAC) and aid in their early detection. However, the evidence for this is debated. This scoping review aims to evaluate the current evidence for their use in this setting.MethodsA literature search was performed using MEDLINE via PubMed, Scopus, Web of Science, Cochrane Library, and . Primary studies published between January 2000 and September 2023 that assessed intra-abdominal drain placement and post-operative IAC formation in emergency gastrointestinal surgery were included.ResultsA total of 26 articles were identified. There was no strong evidence to suggest that prophylactic intra-abdominal drain placement influences the formation of IAC in emergency gastrointestinal procedures. There was a suggestion that drain placement may increase the rate of surgical site infection and length of hospital stay. However, current studies on the topic are of poor quality and high risk of bias.ConclusionThe undifferentiated use of drains in emergency gastrointestinal surgery should not be encouraged. Drain placement should be specific to the clinical context. Higher quality research is warranted to better understand the influence drain placement has on post-operative outcomes. Current practice of intra-abdominal drain placement in emergency gastrointestinal surgery is varied. The evidence base for the benefit of intra-abdominal drain placement is poor and there is some evidence to suggest increased morbidity with their use. Prophylactic drain placement in emergency gastrointestinal surgery should be deployed judiciously and be specific to the clinical context. image