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General Thoracic and Cardiovascular... Jun 2016Since chest tubes have been routinely used to drain the pleural space, particularly after lung surgery, the management of chest tubes is considered to be essential for... (Review)
Review
Since chest tubes have been routinely used to drain the pleural space, particularly after lung surgery, the management of chest tubes is considered to be essential for the thoracic surgeon. The pleural drainage system requires effective drainage, suction, and water-sealing. Another key point of chest tube management is that a water seal is considered to be superior to suction for most air leaks. Nowadays, the most common pleural drainage device attached to the chest tube is the three-bottle system. An electronic chest drainage system has been developed that is effective in standardizing the postoperative management of chest tubes. More liberal use of digital drainage devices in the postoperative management of the pleural space is warranted. The removal of chest tubes is a common procedure occurring almost daily in hospitals throughout the world. Extraction of the tube is usually done at the end of full inspiration or at the end of full expiration. The tube removal technique is not as important as how it is done and the preparation for the procedure. The management of chest tubes must be based on careful observation, the patient's characteristics, and the operative procedures that had been performed.
Topics: Chest Tubes; Device Removal; Drainage; Humans; Lung; Pleura; Pleural Cavity; Pneumonectomy; Suction; Thoracostomy
PubMed: 27048219
DOI: 10.1007/s11748-016-0646-z -
The Journal of Foot Surgery 1985Closed wound suction drainage may have application to certain podiatric surgical procedures. It can be used to reduce postoperative edema and hematoma formation,...
Closed wound suction drainage may have application to certain podiatric surgical procedures. It can be used to reduce postoperative edema and hematoma formation, decrease the possibility of infection, and minimize the chance of external contamination of the surgical site. Certain conditions that may occur after podiatric surgical procedures and that are detrimental to the healing and rehabilitation of the patient but can be obviated by the use of closed suction drainage are illustrated. Drains should be considered in any podiatric surgical procedure that results in the creation of large voids or causes substantial bleeding as occurs in large resections of bone. Included in this would be any plastic surgical procedures or amputations of the foot.
Topics: Catheterization; Foot; Hematoma; Humans; Podiatry; Postoperative Complications; Pressure; Suction; Wound Infection
PubMed: 3973352
DOI: No ID Found -
The Journal of Bone and Joint Surgery.... Oct 1961
Topics: Bone and Bones; Drainage; Humans; Orthopedic Procedures; Orthopedics; Suction
PubMed: 14040185
DOI: No ID Found -
BMC Musculoskeletal Disorders Aug 2021The use of drains reportedly does not improve surgical outcomes after hip replacement. There is still a lack of strict recommendations for drain placement after primary... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The use of drains reportedly does not improve surgical outcomes after hip replacement. There is still a lack of strict recommendations for drain placement after primary hip replacement. This study aimed to assess the safety of not using suction drainage after primary hip replacement in a population of patients undergoing extended thromboprophylaxis.
METHODS
In this prospective randomized study, all patients were qualified for primary hip replacement and were divided into two groups: with and without drainage. The inclusion criterion was idiopathic hip osteoarthritis. The exclusion criteria were secondary coxarthrosis, autoimmune disease, coagulopathy, venous/arterial thrombosis, hepatic/renal insufficiency, cement, or hybrid endoprostheses. We performed an intention-to-treat analysis. Clinical, laboratory, and radiographic parameters were measured for the first three days after surgery. Hematoma collection, due to extended thromboprophylaxis, in the joint and soft tissues was evaluated precisely. The patients underwent follow-up for 30 days.
RESULTS
The final analysis included a total of 100 patients. We did not find any significant statistical differences between groups in terms of hip fluid collection (9.76 vs. 10.33 mm, with and without drainage, respectively; mean difference, 0.6 mm; 95 % confidence interval [CI] -2.8 to 3.9; p = 0.653), estimated blood loss (1126 vs. 1224 ml; mean difference, 97.1 ml; 95 % CI -84.1 to 278.2; p = 0.59), and hemoglobin levels on postoperative day 3 (11.05 vs. 10.85 g/dl; mean difference, 0.2; 95 % CI -2.1 to 2.5; p = 0.53). In addition, the other parameters did not show significant differences between groups. Notably, two cases of early infections were observed in the no-drainage group, whereas there were no such complications in the drainage group.
CONCLUSIONS
We conclude that the use of closed suction drainage after primary hip replacement is a safe procedure in patients undergoing extended thromboprophylaxis. Further research is warranted to validate these findings.
TRIAL REGISTRATION
The study was successfully registered retrospectively at Clinicaltrial.gov with the identification number NCT04333264 03 April 2020.
Topics: Anticoagulants; Arthroplasty, Replacement, Hip; Drainage; Humans; Postoperative Complications; Prospective Studies; Retrospective Studies; Suction; Venous Thromboembolism
PubMed: 34389016
DOI: 10.1186/s12891-021-04583-0 -
Plastic Surgical Nursing : Official... 2013Closed suction drains are indicated in a wide array of postoperative settings, with many distinct drainage systems available to the surgeon. The purpose of this study... (Comparative Study)
Comparative Study
BACKGROUND
Closed suction drains are indicated in a wide array of postoperative settings, with many distinct drainage systems available to the surgeon. The purpose of this study was to compare the suction gradients achieved using 2 different sizes of suction reservoirs and 2 different techniques for generating negative pressure.
MATERIALS AND METHODS
Drainage reservoirs of 100 and 400 ml were chosen to evaluate their ability to achieve suction. Suction was established in both sizes of drains by pressing the sides of the reservoir together or by pushing the bottom of the reservoir toward the top. Negative pressures were recorded with the reservoir empty, and after every 10-ml addition of saline. Averages were graphed to illustrate the applied suction over a range of drain volumes.
RESULTS
The 100-ml drainage system reached a peak suction of -117.6 mmHg, while the 400-ml drainage system reached only a peak suction of -71.4 mmHg. Both of the maximum suction readings were achieved using the full-squeeze technique. The bottom-pushed-in technique did not result in any sustained measurable levels of suction using either of the reservoir volumes.
CONCLUSIONS
Smaller drain reservoirs are more successful in generating a high initial suction than larger reservoirs, especially when the volume of fluid in the drain is relatively low. In all sizes of drains, compressing the sides of the reservoir is a far better technique for establishing negative pressure than pressing the bottom of the drain up toward the top.
Topics: Equipment Design; Humans; Pressure; Suction
PubMed: 23446508
DOI: 10.1097/PSN.0b013e31828425db -
Archives of Orthopaedic and Trauma... Feb 2023Closed suction drainage is an established procedure in arthroscopic surgery. It is intended to reduce the retention of wound and irrigation fluids, which form the basis... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
Closed suction drainage is an established procedure in arthroscopic surgery. It is intended to reduce the retention of wound and irrigation fluids, which form the basis for postoperative swelling, pain, and infection. However, currently, there is no scientific review of the actual benefit of this procedure.
METHODS
Between 2020 and 2021, 84 patients (53 males, 31 females; mean age: 42 years) were prospectively randomised into this study. The patients underwent arthroscopic surgery of the ankle joint with (group A) or without (group B) insertion of a closed suction drain (42 patients per group). Assessments included upper ankle swelling using the figure-of-eight-20 method, pain preoperatively and 48 h postoperatively, and unexpected events within 6 weeks postoperatively.
RESULTS
The measurements performed 48 h postoperatively showed a mean circumferential increase of 1.38 cm (1.48 and 1.28 cm in groups A and B, respectively; p > 0.05) in all patients. The mean pain at rest, assessed using the visual analogue scale (maximum 10 points), was 2.7 and 2.4 in groups A and B, respectively (p > 0.05). Overall, two minor complications occurred: residual swelling in group A and persistent limitation of movement in group B. The average length of hospital stay was 2.4 days (p > 0.05).
CONCLUSIONS
Based on the available data, the routine insertion of a closed suction drainage at the upper ankle does not offer any objective benefit and must be considered obsolete. From both a medical and an economic point of view, the decision to conduct this procedure should be justified on an individual basis.
LEVEL OF EVIDENCE
Level I, prospective randomised trial.
Topics: Male; Female; Humans; Adult; Suction; Prospective Studies; Ankle Joint; Drainage; Minimally Invasive Surgical Procedures; Pain
PubMed: 34401935
DOI: 10.1007/s00402-021-04107-4 -
The Annals of Thoracic Surgery Oct 2016Sufficiently large, prospective randomized trials comparing suction drainage and nonsuction drainage are lacking. The aim of the present study was to compare the effects... (Comparative Study)
Comparative Study Randomized Controlled Trial
BACKGROUND
Sufficiently large, prospective randomized trials comparing suction drainage and nonsuction drainage are lacking. The aim of the present study was to compare the effects of suction drainage and nonsuction drainage on the postoperative course in patients who have undergone lung resection.
METHODS
This prospective, randomized trial included patients undergoing different types of lung resections. On the day of surgery, suction drainage at -20 cm H2O was used. On the morning of the first postoperative day, patients, in whom the pulmonary parenchyma was fully reexpanded, were randomized in the ratio of 1:1. Patients assigned to group A continued with suction drainage, while those assigned to group B underwent nonsuction drainage.
RESULTS
The study included 254 patients, with 127 patients in each group. The drainage volumes were 1098.8 mL and 814.4 mL in groups A and B, respectively (p = 0.0014). The times to chest tube removal were 5.61 days and 4.49 days in groups A and B, respectively (p = 0.0014). Prolonged air leakage occurred in 5.55% of patients in group A and in 0.7% of patients in group B (p = 0.032), and asymptomatic residual air spaces were noted in 0.8% of patients in group A and 9.4% of patients in group B (p = 0.0018).
CONCLUSIONS
Nonsuction drainage is more effective than suction drainage with regard to drainage volume, drainage duration, and incidence of persistent air leakage. However, it is associated with a higher incidence of asymptomatic residual air spaces.
Topics: Adult; Aged; Chest Tubes; Female; Humans; Lung Diseases; Lung Neoplasms; Male; Middle Aged; Pneumonectomy; Postoperative Care; Prospective Studies; Recovery of Function; Reference Values; Risk Assessment; Suction; Survival Rate; Treatment Outcome; Young Adult
PubMed: 27526655
DOI: 10.1016/j.athoracsur.2016.04.066 -
South African Medical Journal =... Sep 2008To compare the outcomes of modified radical mastectomy wounds managed by closed wound drainage with suction and without suction. (Comparative Study)
Comparative Study Randomized Controlled Trial
OBJECTIVE
To compare the outcomes of modified radical mastectomy wounds managed by closed wound drainage with suction and without suction.
METHOD
A prospective randomised trial was conducted at the University College Hospital in Ibadan, and the University of Nigeria Teaching Hospital in Enugu. Fifty women who required modified radical mastectomy for breast cancer were randomised to have closed wound drainage with suction (26 patients) and closed wound drainage without suction (24 patients).
RESULTS
There was no significant difference in the intraoperative and postoperative variables. Suction drainage drained less volume of fluid and stayed for a shorter time in the wound, but the differences were not significant. There was no difference in the length of hospital stay, time to stitch removal, and number of dressing changes. More haematomas and wound infections occurred in the simple drain group while more seromas occurred in the suction drain group, but these were not significant. The suction drain was more difficult to manage and the cost was 15 times higher than the simple drainage system.
CONCLUSION
Closed simple drains are not inferior to suction drains in mastectomy wounds and, considering the cost saving and simplicity of postoperative care, they are preferable to suction drains.
Topics: Adult; Aged; Breast Neoplasms; Chi-Square Distribution; Drainage; Female; Humans; Mastectomy, Modified Radical; Middle Aged; Nigeria; Prospective Studies; Suction; Treatment Outcome
PubMed: 19113053
DOI: No ID Found -
Vascular and Endovascular Surgery 2008Suction drains are widely used in vascular surgery, despite the absence of specific evidence that they confer benefit to patients. There has been no systematic review of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Suction drains are widely used in vascular surgery, despite the absence of specific evidence that they confer benefit to patients. There has been no systematic review of the available evidence, though drainage has been shown to confer no benefit, or indeed harm, across a variety of surgical disciplines. Accordingly, a systematic review and meta-analysis of the current evidence base for closed suction drainage following surgical lower limb revascularization was undertaken.
METHODS
Medline, Embase, trial registries, conference proceedings, and article reference lists were searched to identify randomized controlled trials of the use of surgical drains. The primary outcomes were wound infection, seroma/lymphocele formation, and hematoma formation. Pooled odds ratios were calculated for categorical outcomes.
RESULTS
Four trials containing 429 groin wounds were eligible for inclusion. There was no significant effect on wound infection, seroma/lymphocele formation, or hematoma formation.
CONCLUSION
Our meta-analysis suggests that no benefit is conferred by wound drainage following lower limb revascularization. The practice incurs avoidable expense and should not be routinely used.
Topics: Arteries; Cost-Benefit Analysis; Evidence-Based Medicine; Hematoma; Humans; Lower Extremity; Lymphocele; Odds Ratio; Randomized Controlled Trials as Topic; Risk Assessment; Seroma; Suction; Surgical Wound Infection; Treatment Outcome; Vascular Surgical Procedures
PubMed: 18299318
DOI: 10.1177/1538574407313514 -
BMC Surgery Jan 2023Although laparoscopic total extraperitoneal (TEP) inguinal hernia repair has the advantages of less bleeding, less trauma, less pain, and fast recovery, there are...
BACKGROUND
Although laparoscopic total extraperitoneal (TEP) inguinal hernia repair has the advantages of less bleeding, less trauma, less pain, and fast recovery, there are several issues that need to be addressed. This study aims to evaluate the effectiveness of preperitoneal closed‑suction drainage on reducing postoperative complications in TEP inguinal hernia repair.
METHODS
A retrospective analysis of 122 patients who underwent TEP inguinal hernia repair between June 2018 and June 2021 was performed. The patients were divided into the drainage group and the non-drainage group according to whether the drainage tube was placed or not. Clinical data, surgical procedures and outcome of these patients were collected and analyzed to assess the effectiveness of drainage.
RESULTS
A total of 122 patients undergoing TEP surgery were screened, of which 22 were excluded. Most of the patients were male with right indirect inguinal hernia. There was no difference in the mean length of hospital stay between the two groups. Postoperative pain was alleviated by preperitoneal closed‑suction drainage 24 h after operation (p = 0.03). The rate of complications such as scrotal edema, seroma and urinary retention in the drainage group was significantly lower than that in the non-drainage group (p < 0.05). Multivariate regression analysis showed that drainage was beneficial to reduce postoperative complications (OR, 0.015; 95% CI, 0.002-0.140; p < 0.01). In addition, it was worth noting that in subgroup analysis, patients with hernia sac volume > 10 cm might receive more clinical benefits by placing drainage tube.
CONCLUSION
In TEP inguinal hernia repair, placing drainage tube is a simple and feasible traditional surgical treatment, which can promote postoperative recovery without increasing the risk of infection, especially in patients with large hernia sac volume.
Topics: Humans; Male; Female; Hernia, Inguinal; Suction; Retrospective Studies; Herniorrhaphy; Postoperative Complications; Laparoscopy; Pain, Postoperative; Surgical Mesh; Treatment Outcome
PubMed: 36650526
DOI: 10.1186/s12893-022-01900-9