Prophylactic Abdominal Drains

The concept has been reaffirmed that bacteria migrate from the skin to the interior of an abdominal wound via drains. It has been shown that obvious infection developed in nine out of ten splenectomized dogs in which drains were placed before closure, but not in dogs with no drains. Fifty patients were subjected to abdominal procedures followed by insertion of abdominal drains. Bacterial growths from cultures of the interior portion of their drains, upon removal, revealed that in 17 out of 50 of these patients, there were definite skin contaminants on the interior part of their drains. These findings strongly suggest that bacteria do migrate via the drain into the interior. The authors seriously question the routine placement of prophylactic abdominal drains, in view of the increased virulence reported even among commensal microorganisms which migrate down these drains.