Spinal drainage output and associated factors of improvised versus standard surgical drains among postoperative patients at Mulago Hospital : a comparative study

Abstract

Introduction: Surgical drains play a vital role in preventing fluid accumulation in patients who undergo surgery. The scarcity and cost challenges of standard surgical drains lead healthcare workers to employ improvised drains for fluid removal at surgical sites. However, the knowledge gap regarding the drainage output and determining factors of improvised drains necessitates comprehensive studies. This becomes particularly critical in the context of the ongoing comparative study, where knowledge of improvised gravity-assisted and standard surgical drains are crucial for informing surgical decisions and optimizing postoperative care for spine patients at Mulago Hospital. Study objective: To compare the drainage output and associated factors of improvised versus standard surgical drains in postoperative spine patients at Mulago national referral hospital. Methods: This was a prospective comparative cohort study carried out among postoperative spine patients at Mulago hospital for a period of three (3) months. 58 Participants were recruited consecutively in the two arms; those who had standard surgical drains (25) and those with improvised surgical drains (33). The drained fluid was collected using already calibrated bags/reservoirs. The readings in millilitres (MLS) were recorded daily up to day 2 postoperatively. Data were collected using a pretested questionnaire, entered into EPI DATA and then exported to Microsoft Excel sheet and imported to STATA 14 for cleaning and analysis. Logistic regression was employed to establish factors associated with surgical site drainage output. Results: Significant risk factors for increased drainage output were; age above 50 years (ARR: 1.96, CI: 1.19-3.23, P=0.006), type of surgery with instrumentation (ARR: 1.97, CI: 1.242-3.13, P=0.004) and surgical site in the lumbar region with ARR: 6.72, CI: 1.602-343, P=0.004). Comorbidities and sex didn’t significantly influence surgical site drainage output in this study (ARR: 1.23, CI: 0.72-2.01, P=0.479), (ARR: 0.88, CI: 0.50-1.52, P=0.639). Conclusion: This study showed that standard surgical drains work better than improvised drains. However, the difference in drainage output was not significant. Age above 50years, type of surgery (instrumented) and surgical site (lumbar) were found to be the factors that increased drainage output. Smoking, alcohol, levels of surgery, preoperative medications, mobility of the patient and drainage bag placement did not influence drainage output among postoperative spine patients.