ROUTINE SUBCUTANEOUS DRAIN VERSUS NO DRAIN IN CAESAREAN SECTION FOR OBESE WOMEN- A PROSPECTIVE OBSERVATIONAL COMPARATIVE STUDY

Abstract

Background: The rate of Caesarean section is going up globally due to various
reasons despite strong recommendations by the World Health Organisation to reduce
the same. As with any surgery, caesarean sections are associated with many wound
complications, and the prevalence of which is higher in obese mothers. Use of a
subcutaneous drain to prevent wound complications is a common practice.
Aim: To compare clinical outcomes of subcutaneous drain versus no drain in
caesarean section for obese women.
Methods: This hospital-based prospective observational comparative study was
conducted from June 2018 to May 2019 among 180 obese pregnant women who
underwent cesarean section in the department of Obstetrics and Gynaecology, R G
Kar Medical College, Kolkata. The participants were divided into two groups, with
90 women in each group based on inclusion and exclusion criteria. A subcutaneous
drain was inserted in women of Group-1 (n=90), and no subcutaneous drain was
given in Group-II (n=90). Data collection and comparisons were done on clinical
outcomes between the two study groups. Chi-square tests were used for categorical
data, and Student's t-test was used for continuous data. Statistical significance in all
evaluations was defined as P<0.05.
Result: The wound seroma and post-operative pain were sign i fi cant l y higher in
women having no subcutaneous drain after cesarean section. Wound seroma was
seen in 10% of the drain group and 21.1% of those without a drain (P=0.04). Postoperative pain was monitored as the Numerical Pain Rating Scale. Mild pain (1-3) in
22 cases in the drain group versus 11 cases in without drain group; moderate pain (4-
6) in 66 cases in drain group versus 67 cases in without drain group; severe pain (7-
10) in 2 cases in drain group versus12 cases in the without-drain group (P=0.004).
Conclusion: Post-caesarean subcutaneous drain placement in obese women has
significantly reduced the post-caesarean wound complications like wound seroma
and postoperative pain.