Effectiveness of Subcutaneous Negative-Suction Drain on Surgical Site Infection After Ileostomy Reversal: A Propensity Score Matching Analysis

Background/Objective: Surgical site infection (SSI) is a leading common condition after ileostomy reversal (IR). However, evidence is unclear that subcutaneous negative-suction drainage (SND) reduces the incidence of SSI. This study aimed to investigate whether SND effectively reduced the incidence of SSI. Methods: We retrospectively analyzed the records of 531 patients who underwent IR at Incheon St. Mary's Hospital between June 2005 and December 2020. SND was classified into two groups based on its presence or absence. The estimated risk of SSI was calculated using the surgical risk calculator of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). After 1:1 propensity score matching (PSM) using the estimated risk of SSI, we analyzed the two group's postoperative outcomes, including SSI rates. Results: After PSM, there was no difference in demographics between the two groups; however, the reversal interval was longer in the SND group than in the no SND group (193.3 +/- 151.6 vs. 151.5 +/- 141.0 days, p = 0.005). The incidence of SSI was lower in the SND group than in the no SND group (5.2% vs. 13.0%, p = 0.013). Conclusions: SND insertion can reduce the incidence of SSI during IR. Therefore, SND insertion should be considered as a basic technique for reducing SSI after IR.