Presence of Biofilms in Drains and Their Relevance to Surgical Site Infections

Biofilms commonly develop in indwelling medical devices such as contact lenses, central venous catheters, mechanical heart valves, peritoneal dialysis catheters, urine catheters and drains. Drains are used extensively in all types of surgeries for various purposes. With the potential benefits, they are prone to develop biofilms and increase the risk of surgical site infections. However, there are not many studies correlating the presence of biofilms in drains with surgical site infections and other factors. This prospective observational study was conducted on 143 patients who had 183 surgical drains placed intra-operatively and underwent various surgeries. Drains were tested for the presence of biofilms and correlated with the type of surgery, duration of drain kept in the site and incidence of surgical site infections. There was a significant association between the presence of biofilms in drains with the type of surgery (p = 0.014), duration of the drain in place (p = 0.087) and the incidence and the grades of surgical site infections (p = 0.001). The type of drains was also significant (p = 0.005). Surgical drains are prone to develop biofilms. Drains placed in patients with contaminated and dirty surgeries, increased duration in situ, and non-vacuum abdominal drains had higher incidence. Judicious use of drains with early removal will decrease the biofilm development and may reduce surgical site infections.