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Online care platforms as a viable option for drain management after abdominal wall reconstruction
Katrina Thede MD
Paul Szotek MD
Ascension St Vincent Hospital
2024-01-14
Presenter: Katrina Thede
Affidavit:
The majority of the work on this project was performed by the resident and represents their original work
Director Name: Paul Szotek
Author Category: Other Specialty Resident
Presentation Category: Clinical
Abstract Category: General Reconstruction
Background:
Closed suction drainage is traditionally used after abdominal wall reconstruction (AWR) to mitigate complications like seroma and hematoma. Management of these drains traditionally require patients to have multiple visits to the office for monitoring and removal. We present a model for virtual drain management using a HIPAA-compliant online care platform.
Method:
We performed a retrospective review of 50 patients who underwent open AWR with onlay mesh from December 2020 to October 2023 by one surgeon. 15Fr hubless drains were used in each case. The patient was instructed to measure drain outputs and send a picture through an online care platform. Based on this, instructions were provided on when and how to remove the drain. Data was collected including, age, sex, procedure performed, mesh type, drain removal date, and output volume at time of removal. Complications included wound breakdown and development of fluid collections that required IR drainage.
Results:
31 patients with 34 drains were included in the study. No drains required an office visit for removal. Drains were maintained an average of 16 days. The average volume at time of removal was 12ml. Overall complication rate was 15% (5/34). 3 patients required IR drain placement and 2 patients had wound breakdown requiring local wound care. There was a 9% complication rate from the drains. 2 patients removed their drains too early and 1 patient the drain fell out early.
Conclusion:
Drain management through an online care platform is a viable option for patients and physicians.
