Surgical Site Infections and Aspirative Drain Use: Bridging Evidence and Clinical Practice

Abstract

Background: The role of aspirative drains in preventing surgical site infections (SSIs) remains controversial. Although widely used in multiple surgical specialties, evidence regarding their impact on infection risk is inconsistent. This study aimed to assess healthcare professionals’ perceptions of aspirative drains as potential SSI risk factors and to examine how these beliefs influence attitudes toward the prolongation of antibiotic prophylaxis. Methods: A descriptive cross-sectional survey was conducted in October 2023 at the Trauma University Hospital in Tirana, Albania. Eighty-six healthcare professionals (67 attending surgeons, 6 residents, and 13 operating room nurses) across four surgical specialties participated. The structured questionnaire evaluated perceptions regarding drain-related SSI risk and support for prolonging postoperative antibiotic prophylaxis after drain application. Descriptive statistics and chi-square tests were performed using SPSS v20.0. Results: Overall, 43.0% (n = 37) of respondents believed that aspirative drains increase SSI risk. Although this perception was not significantly associated with professional role or years of experience (p > 0.05), less experienced clinicians (<10 years) showed a higher tendency to perceive drains as risky (56.5%). Among those who believed drains increase infection risk, 67.6% supported prolonging postoperative antibiotic prophylaxis. A statistically significant association was observed between years of experience and support for prolonged prophylaxis (χ² = 14.81, p = 0.0006), with less experienced professionals more likely to favor extended antibiotic use. Conclusion: A substantial proportion of healthcare professionals perceive aspirative drains as contributing to SSI risk, and this perception significantly influences attitudes toward prolonged antibiotic prophylaxis. Targeted educational initiatives and standardized institutional protocols are needed to align clinical practice with current evidence and antimicrobial stewardship principles.

Received: 17 January 2026 / Revised: 24 February 2026 / Accepted: 7 March 2026 / Published: 25  March 2026