Use and Abuse of Intraperitoneal Drains In Colon Surgery

Abstract

In 1887 Robert Lawson Tait, a violent opponent of Lister's concepts of the relationship between bacteria and disease, wrote the familiar phrase: When in doubt, drain. Three quarters of a century later this remains an unresolved problem for the physician performing colonic surgery. When in doubt, should one drain? Even in Tait's day it was demonstrated experimentally that it is not possible to drain the entire peritoneal cavity. <h3>History</h3> In the second century AD Aurelius Celsus, a Roman nobleman, applied what he learned from Hippocratic writings and utilized empyema tubes to drain ascitic fluid. Ambroise Pare (1510-1590) developed paracentesis tubes of gold and silver, and Lorenz Heister (1683-1758), a leading German surgeon, began using wicks of gauze. This was the first attempt to utilize the principle of capillary action in removing ascites. Ephraim McDowell (1771-1830), a Kentucky surgeon, in performing his first ovariotomy, left long ligatures on the pedicles which