Global Guidelines for the Prevention of Surgical Site Infection. Geneva: World Health Organization; 2018. Web Appendix 27, Summary of a systematic review on antimicrobial prophylaxis in the presence of a drain and wound drain removal.
In conclusion, the available evidence can be summarized as follows:
Prolonged antibiotic prophylaxis in the presence of a wound drain vs. perioperative prophylaxis alone (PICO question 1, comparison 1)
Overall, a low quality of evidence shows that prolonged antibiotic prophylaxis in the presence of a wound drain has neither benefit nor harm in reducing the SSI rate when compared to perioperative prophylaxis alone (single dose before incision and possible intraoperative additional dose/s according to the duration of the operation).
Early removal vs. late removal of wound drains (PICO question 2, comparison 2)
Very low quality evidence shows that that the early removal of wound drains has neither benefit nor harm in reducing the SSI rate when compared to late removal.