PMID- 27138020
OWN - NLM
STAT- MEDLINE
DCOM- 20170828
LR  - 20220317
IS  - 1435-2451 (Electronic)
IS  - 1435-2443 (Linking)
VI  - 401
IP  - 4
DP  - 2016 Jun
TI  - Necessity of subcutaneous suction drains in ileostomy reversal (DRASTAR)-a 
      randomized, controlled bi-centered trial.
PG  - 409-18
LID - 10.1007/s00423-016-1436-x [doi]
AB  - PURPOSE: Data regarding length of hospital stay of patients undergoing ileostomy 
      reversal are very heterogeneous. There are many factors that may have an 
      influence on the length of postoperative hospital stay, such as postoperative 
      wound infections. One potential strategy to reduce their incidence and to 
      decrease hospital stay is to insert subcutaneous suction drains. The purpose of 
      this study was to examine the influence of the insertion of subcutaneous suction 
      drains on hospital stay and postoperative wound infections in ileostomy reversal. 
      Risk factors for postoperative wound infection were determined. METHODS: This is 
      a randomized controlled two-center non-inferiority trial with two parallel 
      groups. The total length of hospital stay as primary endpoint and the occurrence 
      of a surgical site infection, the colonization of the abdominal wall with 
      bacteria, and the occurrence of hematomas/seromas as secondary endpoints were 
      monitored. RESULTS: One hundred eighteen patients with elective ileostomy 
      reversal were included. Fifty-nine patients were randomly assigned to insertion 
      of a subcutaneous suction drain, and 59 patients were randomly assigned to 
      receive no drain. After 3 months of follow-up, 50 patients in the group with 
      drain and 53 patients in the group without drain could be analyzed. Median total 
      length of hospital stay was 8 days in the SD group and 9 days in the group 
      without SD (p = 0.17). Fourteen percent of patients with SD and 17 % without SD 
      developed SSI, p = 0.68. Multivariate analysis revealed anemia (p < 0.01), 
      intraoperative bowel perforation (p = 0.02) and resident (p = 0.04) or fellow 
      (p = 0.048) performing the operation as risk factors for SSI. CONCLUSIONS: This 
      trial shows that the omission of subcutaneous suction drains is not inferior to 
      the use of subcutaneous suction drains after ileostomy reversal in terms of 
      length of hospital stay, surgical site infections, and hematomas/seromas.
FAU - Lauscher, J C
AU  - Lauscher JC
AD  - Department of General, Visceral, and Vascular Surgery, Charite Campus Benjamin 
      Franklin, Hindenburgdamm 30, 12200, Berlin, Germany. 
      johannes.lauscher@charite.de.
FAU - Schneider, V
AU  - Schneider V
AD  - Department of General, Visceral, and Vascular Surgery, Charite Campus Benjamin 
      Franklin, Hindenburgdamm 30, 12200, Berlin, Germany.
FAU - Lee, L D
AU  - Lee LD
AD  - Department of General, Visceral, and Vascular Surgery, Charite Campus Benjamin 
      Franklin, Hindenburgdamm 30, 12200, Berlin, Germany.
FAU - Stroux, A
AU  - Stroux A
AD  - Institute of Biometry and Clinical Epidemiology, Charite Campus Mitte, 
      Chariteplatz 1, 10098, Berlin, Germany.
FAU - Buhr, H J
AU  - Buhr HJ
AD  - German Society for General and Visceral Surgery, Schiffbauerdamm 40, 10117, 
      Berlin, Germany.
FAU - Kreis, M E
AU  - Kreis ME
AD  - Department of General, Visceral, and Vascular Surgery, Charite Campus Benjamin 
      Franklin, Hindenburgdamm 30, 12200, Berlin, Germany.
FAU - Ritz, J P
AU  - Ritz JP
AD  - Department of General and Visceral Surgery, HELIOS Kliniken Schwerin, Wismarsche 
      Strasse 393-397, 19049, Schwerin, Germany.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20160501
PL  - Germany
TA  - Langenbecks Arch Surg
JT  - Langenbeck's archives of surgery
JID - 9808285
SB  - IM
MH  - Adult
MH  - Aged
MH  - Drainage/instrumentation
MH  - Female
MH  - Humans
MH  - *Ileostomy
MH  - Intestinal Diseases/*surgery
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Operative Time
MH  - Reoperation
MH  - Risk Factors
MH  - Suction/instrumentation
MH  - Surgical Wound Infection/etiology/*prevention & control
OTO - NOTNLM
OT  - Hospital stay
OT  - Ileostomy closure
OT  - Subcutaneous suction drains
OT  - Surgical site infection
EDAT- 2016/05/04 06:00
MHDA- 2017/08/29 06:00
CRDT- 2016/05/04 06:00
PHST- 2016/01/07 00:00 [received]
PHST- 2016/04/13 00:00 [accepted]
PHST- 2016/05/04 06:00 [entrez]
PHST- 2016/05/04 06:00 [pubmed]
PHST- 2017/08/29 06:00 [medline]
AID - 10.1007/s00423-016-1436-x [pii]
AID - 10.1007/s00423-016-1436-x [doi]
PST - ppublish
SO  - Langenbecks Arch Surg. 2016 Jun;401(4):409-18. doi: 10.1007/s00423-016-1436-x. 
      Epub 2016 May 1.