Clinical Outcomes of Drain Versus No Drain in Midline Laparotomy Closure: A Retrospective Comparative Study

Abstract

The value of routine subcutaneous drainage after midline laparotomy remains uncertain. Methods: This retrospective comparative study included 60 patients undergoing midline laparotomy closure between April 2025 and March 2026; 30 received a closed-suction subcutaneous drain and 30 had no drain. Outcomes (surgical-site infection [SSI], seroma, dehiscence, reintervention, and length of stay) were assessed at 30 days and compared using Fisher exact tests for categorical outcomes and an independent-samples t test for length of stay. Results: Crude complication rates were numerically higher in the drain group, but on reanalysis of the reported event counts none of the differences in SSI (7/30 vs 3/30; p = 0.30), seroma (6/30 vs 2/30; p = 0.25), or overall complications (12/30 vs 6/30; p = 0.16) were statistically significant. Only length of stay differed significantly (8.5 ± 2.1 vs 6.2 ± 1.8 days; p < 0.001). The p values displayed on the source poster were inconsistent with the event counts and have been recomputed. Conclusion: The reported data do not demonstrate a significant difference in wound-complication rates between groups; the only significant finding was a longer hospital stay in the drain group. Given the retrospective, mixed-indication design, confounding by indication cannot be excluded, and a prospective, adequately powered, wound-class-stratified study is required. Wound complications remain an important source of postoperative morbidity after laparotomy. Subcutaneous drains may evacuate dead space and reduce seroma, but routine use lacks universal endorsement and guideline consensus [1,2]. Published evidence suggests that drain effects may differ by wound contamination and baseline risk, reinforcing the need for careful patient selection [3,4,7].