Summary of best evidence for drainage tube management to prevent surgical site infections

OBJECTIVE: To conduct a narrative evidence synthesis integrating clinical practice guidelines, systematic reviews, meta-analyses, expert consensus, and primary studies to summarize the best available evidence related to drainage tube management for the prevention of surgical site infections (SSI), and to develop an evidence-based framework for clinical standardized management strategies. METHODS: Utilizing the "6S" evidence model, a systematic search was conducted on various national and international databases and websites up to October 31, 2025, including WHO, CDC, NICE, SHEA/IDSA, APIC, GIN, Medlive Guideline Network, The Cochrane Library, Joanna Briggs Institute (JBI) Evidence Synthesis, PubMed, Web of Science, Embase, CINAHL, ClinicalTrials.gov, CBM, CNKI, VIP, and WanFang. The search aimed to extract relevant evidence regarding the management of drainage tubes to prevent SSI. Two researchers independently performed the literature screening, quality assessment, evidence extraction, and integration of the literature. RESULTS: A total of 21 publications were included, comprising 4 guidelines, 4 expert consensuses and opinions, 2 evidence summaries, 6 systematic reviews, 3 randomized controlled trials, and 2 cohort studies. A total of 40 pieces of best evidence were summarized, covering ten aspects: indications and selection for drainage tube placement, intraoperative principles of drainage tube placement, daily maintenance of drainage tubes, management of drainage tube blockage, infection prevention measures, application of antimicrobial drugs, timing for drainage tube removal, monitoring and assessment of drainage fluid, patient health education, and referral indications. CONCLUSION: The best evidence summary for the management of drainage tubes to prevent SSI provides a preliminary evidence-based reference for the standardized management practice of drainage tubes in clinical settings. Clinicians and nursing staff should integrate specific circumstances and professional judgment to translate evidence into practice, thus providing scientific management and guidance for patients with drainage tubes.