Can sub‐cutaneous drain safely counter debilitating surgical emphysema? A retrospective study in quest for an answer

Abstract

AbstractLiterature evidence on sub‐cutaneous drain insertion in severe surgical emphysema (SE) is lacking. We retrospectively reviewed the clinical notes of 5 patients who underwent insertion of sub‐cutaneous drains to manage SE of various aetiologies between September 2022 to August 2023 in a single district general hospital in the UK. Case history, outcome following sub‐cutaneous drain insertion, and side effects due to the procedure were collected. Clinical decompression were noticed within an hour of drain insertion in all patients. Radiological resolution ranged between 2 and 10 days with a median 3 days and mean of 4.8 days. Patients with uni‐lateral sub‐cutaneous drain required more time for radiological improvement than patients on bi‐lateral drains (median 6.5 vs. 2, mean 6.5 vs. 3.6). Maximum duration for resolution was 10 days for patients receiving uni‐lateral sub‐cutaneous drain versus 7 days in patients having bi‐lateral drains. Only one patient had no prior lung disease making it difficult to comment if having healthy lungs affects outcomes. Sub‐cutaneous drain insertion is a safe procedure which can accelerate recovery in severe SE.