Table3. Criteria for percutaneous and surgical drainage of infected collections

Percutaneous drainage

Surgical drainage

Unilocular collection/abscess

Low viscosity of drain fluid

Drain route not traversing intra-abdominal organs or thorax

Multilocular collections/abscesses Multiple, non-communicating collections High viscosity of drain fluid

Percutaneous drain route traversing intraabdominal organs or thorax

Tricks of the Senior Surgeon

■ Whenever indicated, always use closed drain systems and keep drains as short as possible to minimize the risk of retrograde infections.

■ Place drains near but never in direct contact to the anastomotic sutures to prevent drain-induced erosions or drain-induced anastomotic leaks.

■ When drains are not productive, do not rely on them! Drains could be occluded or obstructed by adjacent tissue.

■ Try to position intraperitoneal drains such that the drain does not rub against or lie in direct contact with blood vessels or hollow organs in an attempt to prevent drain erosions.


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