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Drain tube use in incisional hernia repair: a national survey

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Abstract

Purpose

There is debate regarding the use of drain tubes in incisional hernia repair. This has become topical in Australia, with a court judge suggesting that drain tubes are mandatory. There continues to be a lack of evidence to support generalised decision-making regarding the use of drain tubes.

Methods

The general surgeon membership of General Surgeons Australia (GSA) were surveyed regarding incisional hernia repair, their use of drains, and the decision-making behind their use.

Results

A total of 196 surgeons’ survey responses were analysed. Most surgeons perform less than 20 incisional hernia repairs per year (78%), prefer an open approach (78%), and preferably perform a pre-peritoneal (sub-lay) repair (53%). There was a variety of approaches to leaving a drain, with the most common answer being “sometimes” (31.28%) and an equal number of surgeons claiming to always or never leaving a drain (11.79% each). There was also no consensus in the duration the drain should stay in, with most surgeons averaging less than 5 days. Interestingly, there was a range of views on the effects of drain tubes, with some surgeons believing drains decreased infections and more believing they increased infections. Most surgeons felt seromas were decreased, but there was increased post-operative pain. The majority of surgeons agreed there was no evidence to support their beliefs.

Conclusion

Placement of drain tubes is not universally practiced by the general surgeons who participated in the survey. The lack of evidence is reflected by a varied approach to incisional hernia repair and the use of drain tubes.

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Abbreviations

GSA:

General Surgeons Australia

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Author information

Authors and Affiliations

  1. Northern Health, 185 Cooper Street, Epping, VIC, 3076, Australia

    Y. Luo, S. Mohammed Jinnaah, D. Masood & R. Hodgson

  2. University of Melbourne, 185 Cooper Street, Epping, VIC, 3076, Australia

    R. Hodgson

Authors
  1. Y. Luo
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  2. S. Mohammed Jinnaah
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  3. D. Masood
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  4. R. Hodgson
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Contributions

YL and RH conceived and designed the study. YL collected data. YL performed analysis. YL drafted the manuscript. RH provided senior supervision and contributed to the direction of the project. All authors edited the manuscript and approved the final version for submission.

Corresponding author

Correspondence to R. Hodgson.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study, where involving human participants was in accordance with the ethical and governance standards of the institutions involved. Ethical and governance approval number: ALR 07.2018.

Human and animal rights

This article only involves human participants and their rights have been observed through compliance with ethical standards as outlined.

Informed consent

Implied consent was used with an introductory paragraph heading the survey, including information on storage and publication of data. This was approved through the above ethical processes.

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Luo, Y., Mohammed Jinnaah, S., Masood, D. et al. Drain tube use in incisional hernia repair: a national survey. Hernia 25, 427–433 (2021). https://doi.org/10.1007/s10029-019-02115-3

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  • DOI: https://doi.org/10.1007/s10029-019-02115-3

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