47 - Reducing Dwell Time: The Role of Guideline-Driven Interventional Rounds in Improving Drain Management Efficiency

Purpose: Percutaneous drainage catheter placement (PDCP) with concomitant antimicrobial therapy (AT) is the first-line treatment for symptomatic fluid collections throughout the body¹. Compared to surgical management or AT alone, PDCP is associated with lower morbidity, mortality and shorter hospital stays^1,2,5. PDCP often are mismanaged, leading to delayed drain removal and avoidable complications such as superimposed infection, malposition, fistulization and poor healing of the insertion site³.

The primary objective of this study is to retrospectively review drain retention time following the introduction of a structured drain service line (SL).

Materials and Methods: A drain management protocol was created based on peer- reviewed, evidence-based practices and consensus recommendations and includes departmental guidelines with recommendations on drain maintenance, interval imaging and interval removal algorithm. Percutaneous drains placed into visceral organs and pleural space were excluded from these guidelines due to the complex and specific management they require. Additional exclusion criteria included no record of drain being placed/removed by IR or admission to surgical service. The SL was implemented in January 2025 with formal rounding on post procedure day 1, as well as every Tuesday and Thursday until drain removal for those admitted to non-surgical services.

Following IRB approval, a retrospective review of all PDCP from January 2025 to June 2025 was performed and compared to cases prior to SL implementation. Non-parametric data was analyzed using Mann-Whitney test. Post-hoc analysis was performed based upon the location of drain placement (abdominal, pelvic, superficial).

Results: A total of 101 cases were reviewed, and 61 (60.4%) were included in the analysis (29 pre and 32 post SL implementation). The mean drain retention time before and after intervention was 16.9 ± 12.4 days (d) and 10.9 ± 8.1 d, respectively (p=0.048). When reviewed by location, retention time decreased following SL implementation for both abdominal drains (16.1 ± 13.8 d to 10.1 ± 7.3 d) and pelvic drains (13.3 ± 7.6 d to 1.6 ± 9.3 d), but did not reach statistical significance (p=0.41 and 0.42 respectively). Superficial drain retention time did not change significantly following SL implementation (p=0.755).

Conclusion: Development and implementation of a drain management protocol and SL implementation led to a reduction in drain retention time with trends toward significance with drains in deep collections within the abdomen and pelvis over superficial drains.