Efficacy of rubber tube drain versus Penrose drain to decrease hospital stay in Ludwig’s angina with upper airway obstruction

Abstract

Abstract
Background: Ludwig's angina is a life-threatening rapid progressive cellulitis resulting in upper
airway obstruction and death. Standard management includes securing the airway and surgical
decompression. A rubber tube (irrigating drain) or Penrose drain is commonly placed in surgical
wounds to facilitate fluid drainage and reduce pressure.

Objective: The objective of this study was to compare the efficacy of rubber tube drain versus
Penrose drain in terms of hospital stay in Ludwig's angina with upper airway obstruction patients.

Methods: This retrospective cohort study included the patients who were admitted to the
Otolaryngology Department, Khon Kaen Hospital, Thailand with Ludwig's angina with upper airway
compromise from January 2013 to August 2023. The demographic data, airway management received, type
of drain, and length of hospital stay were collected.

Results: 131 patients were included in this study. The rubber tube drain was placed in 60 patients
while 71 patients were placed with Penrose drain in the surgical site. There was no statistically
significant difference in age, sex, underlying diseases, cause of infection, duration of symptoms,
and type of airway management between groups (p > 0.05). The mean length of hospital stay in the
rubber drain group was 5.57 ± 2.42 days while the mean length of hospital stay in the Penrose drain
group was 6.83 ± 3.16 days (mean difference 1.26 days, 95% CI 0.28 to 2.25, p = 0.012). There was
no difference in terms of re-operation and re-intubation between groups (p > 0.05).
Conclusions: Rubber tube drain can reduce the duration of hospital stay in Ludwig’s angina
with upper airway compromise patients better than Penrose drain.

Keywords: Ludwig’s angina, airway obstruction, drain, hospital stay