Abstract：
OBJECTIVE: Elective open incisional hernia operations are a frequently performed and complex procedure. Prophylactic drainage is widely practised to prevent local complications, but nevertheless the benefit of surgical drain placement remains a controversially discussed subject. Objective of this analysis was to evaluate the current status of patient care in clinical routine and outcome in this regard.
METHODS: The study based on prospectively collected data of the Herniamed Register. Included were all patients with elective open incisional hernia between 1/2005 and 12/2020 and completed 1-year follow-up. Multiple linear and logistic regression analysis was performed to assess the relation of individual factors to the outcome variables.
RESULTS: Analysed were data from 39,523 patients (28,182 with drain, 11,341 without). Patients with drain placement were significantly older, had a higher BMI, more preoperative risk factors, and a larger defect size. Drained patients furthermore showed a significant disadvantage in the outcome parameters intraoperative complications, general complications, postoperative complications, complication-related reoperations, and pain at the 1-year follow-up. No significant difference was observed with respect to the recurrent rate.
CONCLUSIONS: With 71.3%, the use of surgical drainages has a high level of acceptance in elective open incisional hernia operations. The worse outcome of patients is associated with the use of drains, independent of other influencing factors in the model such as patient or surgical characteristics. The use of drains may be a surrogate parameter for other unobserved confounders.
METHODS: The study based on prospectively collected data of the Herniamed Register. Included were all patients with elective open incisional hernia between 1/2005 and 12/2020 and completed 1-year follow-up. Multiple linear and logistic regression analysis was performed to assess the relation of individual factors to the outcome variables.
RESULTS: Analysed were data from 39,523 patients (28,182 with drain, 11,341 without). Patients with drain placement were significantly older, had a higher BMI, more preoperative risk factors, and a larger defect size. Drained patients furthermore showed a significant disadvantage in the outcome parameters intraoperative complications, general complications, postoperative complications, complication-related reoperations, and pain at the 1-year follow-up. No significant difference was observed with respect to the recurrent rate.
CONCLUSIONS: With 71.3%, the use of surgical drainages has a high level of acceptance in elective open incisional hernia operations. The worse outcome of patients is associated with the use of drains, independent of other influencing factors in the model such as patient or surgical characteristics. The use of drains may be a surrogate parameter for other unobserved confounders.
摘要：
目的：择期开放切口疝手术是一项经常执行且复杂的手术。预防性引流广泛用于预防局部并发症，但尽管如此，手术引流的益处仍然是一个有争议的话题。这项分析的目的是评估患者护理在临床常规和结局方面的现状。
方法：该研究基于前瞻性收集的HerniamedRegister数据。包括所有在2005年1月至2020年12月12日之间选择性开放性切口疝患者，并完成了1年的随访。进行了多元线性和逻辑回归分析，以评估各个因素与结果变量的关系。
结果：分析了39,523例患者的数据（28,182例引流，11,341没有）。引流管放置的患者年龄明显较大，有更高的BMI，更多的术前危险因素，和更大的缺陷尺寸。此外，引流患者在结果参数术中并发症方面表现出明显的劣势，一般并发症,术后并发症,并发症相关的再次手术，和1年随访时的疼痛。在复发率方面没有观察到显着差异。
结论：71.3%，在选择性开放切口疝手术中，外科引流的使用具有较高的接受度。患者的不良预后与使用排水沟有关，独立于模型中的其他影响因素，如患者或手术特征。排水管的使用可能是其他未观察到的混杂因素的替代参数。
方法：该研究基于前瞻性收集的HerniamedRegister数据。包括所有在2005年1月至2020年12月12日之间选择性开放性切口疝患者，并完成了1年的随访。进行了多元线性和逻辑回归分析，以评估各个因素与结果变量的关系。
结果：分析了39,523例患者的数据（28,182例引流，11,341没有）。引流管放置的患者年龄明显较大，有更高的BMI，更多的术前危险因素，和更大的缺陷尺寸。此外，引流患者在结果参数术中并发症方面表现出明显的劣势，一般并发症,术后并发症,并发症相关的再次手术，和1年随访时的疼痛。在复发率方面没有观察到显着差异。
结论：71.3%，在选择性开放切口疝手术中，外科引流的使用具有较高的接受度。患者的不良预后与使用排水沟有关，独立于模型中的其他影响因素，如患者或手术特征。排水管的使用可能是其他未观察到的混杂因素的替代参数。
