Role of Drains in Cases of Peptic Ulcer Perforations: Comparison between Single Drain versus No Drain
Introduction: Peptic ulcer perforation is one of the commonest causes of peritonitis and needs immediate surgical intervention after prompt resuscitation if mortality and morbidity are to be contained.
AIMS & OBJECTIVES: To compare role of Intra-abdominal drains prophylactically after plugging of these perforations single drain or no drain.
Methods: In this study, we compared the relative safety and efficacy of putting single drain prophylactically near operation site or in natural abdominal fossae (hepato-renal pouch or sub hepatic) and no drain in cases of peritonitis due to peptic ulcer perforation. Study was done on 60 patients (one drain put in 30 patients Group A and no drain was put in other 30 patients of Group B). We handle the perforation after thorough peritoneal lavage with warm saline and metrogyl. All the perforation was closed by Grahm’s Patch.
Results: No significant difference between drain and non-drain group as far age and sex concerned. Significant difference was seen in operative duration, hospital stay, wound dehiscence and post-operative fever, intraperitoneal collection or abscess formation. So use of drains are not effective in preventing post-operative infection rather there are chances of its blockage due to debris, intestine or omentum and tubes itself are source of infection as foreign body and there are chances of migration of bacteria from exterior to peritoneal cavity via these drains.
Conclusion: Non drainage of peritoneal cavity after peptic ulcer perforation surgery is an effective method to reduce operative duration, hospital stay and wound dehiscence and post-operative pyrexia.
Key Words: Peptic ulcer, peritonitis, tube drain.