Prophylactic drain placement after emergency general surgery procedures? A scoping review of the literature challenging common practice.

BACKGROUND

This scoping review aims to map the existing literature on the use of prophylactic drainage (PD) after Emergency General Surgery procedures (EGS) and to change the current practice according to evidence.

METHODOLOGY: Data from an exhaustive literature search conducted across Embase (Ovid), Medline(R) ALL (Ovid), Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials was summarized. Literature published between January 2013 and December 2024 was included.

RESULTS

Most studies found better outcomes for the no-drain group. Implementing a drain after EGS procedures potentially increases hospital stays, postoperative pain, and surgical site infection rates. For conditions such as peritonitis and perforated ulcers, only a few studies were available, with some showing benefits of PD.

CONCLUSION

For some conditions, like colorectal emergencies, there is a scarcity of evidence. The outcomes suggest that PD is not recommended in most EGS cases. In high-risk cases, there are some reports on improved outcomes for PD use. Further research is imperative to create science-based clinical guidelines, especially for less-researched conditions.