TY - JOUR
T1 - Patient-performed at-home surgical drain removal is safe and feasible following hernia repair and abdominal wall reconstruction
AU - Bray, Jordan O.
AU - O'Connor, Stephanie
AU - Sutton, Thomas L.
AU - Santucci, Nicole M.
AU - Elsheikh, Mohamed
AU - Bazarian, Alina N.
AU - Orenstein, Sean B.
AU - Nikolian, Vahagn C.
N1 - Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2023/2
Y1 - 2023/2
N2 - Background: Traditionally, surgical drains are considered a relative contraindication to telemedicine-based postoperative care. We sought to assess the safety, feasibility, and outcomes of an at-home patient-performed surgical drain removal pilot program. Methods: A prospective cohort study among patients who were discharged with surgical drains was performed. Patients discharged with drains were given the option for in-clinic, provider-performed removal, or at-home, patient-performed drain removal. Patient demographics, health characteristics, perioperative metrics, and operative outcomes were compared and analyzed. Results: A total of 68 encounters with drain removal were included (at-home: 28%, n = 19; in-clinic: 72%, n = 49), with both groups having similar demographics, except for age (median age of telemedicine-based at-home: 50 vs in-clinic: 62 years, p = 0.03). Patients who opted into at-home, patient-performed drain removal were more likely to have drain removal occur earlier (9 vs 13 days for in-clinic, p < 0.001). In-clinic removal resulted in increased encounters with surgical nursing staff and increased travel time, with no significant difference in complication burden. Conclusions: Patient-performed at-home drain removal is safe and allows for more timely drain removal.
AB - Background: Traditionally, surgical drains are considered a relative contraindication to telemedicine-based postoperative care. We sought to assess the safety, feasibility, and outcomes of an at-home patient-performed surgical drain removal pilot program. Methods: A prospective cohort study among patients who were discharged with surgical drains was performed. Patients discharged with drains were given the option for in-clinic, provider-performed removal, or at-home, patient-performed drain removal. Patient demographics, health characteristics, perioperative metrics, and operative outcomes were compared and analyzed. Results: A total of 68 encounters with drain removal were included (at-home: 28%, n = 19; in-clinic: 72%, n = 49), with both groups having similar demographics, except for age (median age of telemedicine-based at-home: 50 vs in-clinic: 62 years, p = 0.03). Patients who opted into at-home, patient-performed drain removal were more likely to have drain removal occur earlier (9 vs 13 days for in-clinic, p < 0.001). In-clinic removal resulted in increased encounters with surgical nursing staff and increased travel time, with no significant difference in complication burden. Conclusions: Patient-performed at-home drain removal is safe and allows for more timely drain removal.
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U2 - 10.1016/j.amjsurg.2022.09.022
DO - 10.1016/j.amjsurg.2022.09.022
M3 - Article
C2 - 36167625
AN - SCOPUS:85138788107
SN - 0002-9610
VL - 225
SP - 388
EP - 393
JO - American journal of surgery
JF - American journal of surgery
IS - 2
ER -