Ajay Kumar, A (2020) A Comparitive study between Patients of Small and Large Bowel Perforation managed by Stomas with Drains and Without Drains. Masters thesis, Stanley Medical College, Chennai.
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Abstract
INTRODUCTION: Even though studies have proven that usage of drains in patients undergoing ostomy due to perforation was neither effective nor safe but still PRACTICE OF PLACING A DRAIN IS FOLLOWED MANY A TIMES. Drains are placed in view to detect haemorrhage, intra-abdominal pus, reactive effusion, detect leak,surgeons satisfaction. At the same time, there are many drain related complications like infection, omental prolapse, DT related adhesions, DT site hernia For these reasons this comparative study was conducted whether we need drain or not in patients with small and large bowel perforation managed by ostomies METHODS: • Written informed consent will be obtained from all subjects before enrolment in the study • All patients are thoroughly examined. • Patients were divided into two groups into GROUP A and GROUP B by randomization. • Group A patients will receive drain tube and group B will not receive drain tube. • All patients were regularly examined post operatively regarding complications. • All patients were followed up for a period of three months. • All details regarding the study will be recorded according to the pre designed proforma The factors monitored in both the group of patients are DT site pain, DT site infection, DT site omental prolapse, DT site hernia, Postoperative mobility of patients, Number of patients undergoing re surgery, Duration of hospital stay, Operative site wound infection, Other DT unrelated post-op complications RESULTS: The observations are plotted in the above plotted graphs and tables. It shows there is no statistical difference in DT unrelated complications like wound infection, abscess, electrolyte imbalance and burst abdomen even though percentages between two groups vary. Also there is no statistical difference in mobility of patient, number of patients undergoing re surgery and duration of hospital stay between the two groups. But in drain tube patients a good number of drain related complications occur like DT site pain, DT site infection, DT site hernia and DT site omental prolapse. The drain tube site pain occurred in 60%, the drain tube site infection occurred in 16%, the drain tube site hernia occurred in 8% and the drain tube site omental prolapse in 4% patients. Even though the drain unrelated complications is not statistically significant between two groups, the patients with drain tubes had drain related complications which affected the post op period without affecting other complications, mobility and duration of hospital stay. From this we understood that KEEPING A DRAIN for a small and large bowel perforative peritonitis patient managed by ostomy is of NO USE and in turn it causes less significant DT related complications which should be avoided. So surgical drains should be used as when needed. CONCLUSION: In small bowel and large bowel perforation with peritonitis (excluding duodenal perforation) patients managed by ostomies (stoma) DRAIN TUBES DOESN’T play an important role in the post- operative period, instead it causes unnecessary drain related complications. The mobility of patient, rates of re surgery, drain unrelated complications and duration of hospital stay is NOT AFFECTED by drain tube.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221711051 |
| Uncontrolled Keywords: | Small and Large Bowel Perforation, Stomas, Drains and Without Drains, Comparitive study. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 09 Feb 2021 01:00 |
| Last Modified: | 09 Feb 2021 01:00 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/13938 |
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