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Suction Drainage as an Alternative to Prophylactic Antibiotics for Hysterectomy

From the Department of Obstetrics and Gynccology, St. Joseph Mercy Hospital, Pontiac, Michigan

Abstract

A technic is described for suction drainage of the rclropcritoneal space. Its use is evaluated in 150 private patients undergoing vaginal or abdominal hysterectomy and com pared with 150 private control patients. This lechnic resulted in an average of 10 cc of Huid (range. 10-200 cc) heing suclioned from the retroperiloneal space. With this technic febrile morbidity decreased from 26 to 11% for abdominal hysterectomies and from 32 to 8% for vaginal hysterectomies. Information is offered to explain the physiology of posthystcrcctomy infections, the effectiveness of prophylactic antibiotics, and the paradox of a febrile morbidity higher for vaginal than for abdominal hysterectomies. The risks in using prophylactic antibiotics routinely are stated, and suction drainage is suggested as a preferable alternative.