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Journal of Veterinary Emergency and... Mar 2023Active pleural suction devices may be required for continuous drainage of pleural fluid or air. Such devices may not always be available or economical to stock at all...
BACKGROUND
Active pleural suction devices may be required for continuous drainage of pleural fluid or air. Such devices may not always be available or economical to stock at all veterinary hospitals. Three designs of pleural drainage systems adapted from standard suction canisters are proposed.
KEY FINDINGS
The designs were constructed from readily available materials from the veterinary hospital and consist of (1) a 1-bottle system intended for use with pneumothoraces, (2) a 2-bottle system, which can be used for draining air and fluid, and (3) an abbreviated 2-bottle system. The suction pressure was tested using a water manometer for each design. The suction pressure was consistently accurate with designs 1 and 2, with mild fluctuations, intermittently increasing suction pressure in design 1 due to bubbling through the air vent. Design 3 demonstrated a greater degree of pressure fluctuations, which was attributed to having the least water volume, reaching suction pressures up to 1 cm H O above what was set.
SIGNIFICANCE
The improvised devices appear effective, allow accurate delivery of a set suction pressure, and can be rapidly constructed from inexpensive and readily available equipment.
Topics: Animals; Suction; Chest Tubes; Pneumothorax
PubMed: 36156847
DOI: 10.1111/vec.13257 -
Orthopaedic Surgery Dec 2020To investigate whether closed suction drainage (CSD) is related to accelerated rehabilitation of patients after open reduction and internal fixation (ORIF) for closed... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To investigate whether closed suction drainage (CSD) is related to accelerated rehabilitation of patients after open reduction and internal fixation (ORIF) for closed distal femur fractures.
METHODS
This study was a prospective, randomized controlled clinical trial. Between October 2018 and June 2020, 160 closed distal femur fracture patients who were prepared for ORIF were prospectively randomized into two groups: a CSD group with the mean age of 57.91 ± 14.38 years (32 [40%] men and 48 [60%] women) and a non-CSD group with the mean age of 59.73 ± 17.55 years (27 [34%] men and 54 [66%] women). Wound visual analogue scale (VAS) pain scores, peri-wound skin temperature, hematocrit (Hct), hemoglobin (Hb) concentrations, hidden blood loss (HBL), dressing change, period of wound oozing, postoperative blood transfusion, and length of postoperative hospital stay were recorded. Postoperative wound complications, namely wound infections, wound haematoma, wound dehiscence, erythema of wound, and lower limb deep vein thrombosis (DVT) were collected. All the patients were administrated by a single surgical team and followed up for 1 month after the ORIF.
RESULTS
The patients without CSD were identified with lower peri-wound skin temperature and wound VAS pain scores during the first three postoperative days (36.69 ± 0.33 vs 36.86 ± 0.38 °C, P = 0.002; 1.88 ± 0.82 vs 3.15 ± 1.15, P = 0.000). However, both the peri-wound skin temperature and wound VAS pain scores did not differ significantly between the two groups on the fifth postoperative day. In addition, patients with CSD had a longer length of postoperative hospitalization time (11.45 ± 5.95 vs 9.78 ± 4.64 days, P = 0.049). There was no statistically significant difference between CSD and non-CSD groups within 1 month after the ORIF regarding blood loss, period of wound oozing, and postoperative complications, such as incidence of wound infection, haematoma, erythema, dehiscence, and lower limb DVT.
CONCLUSION
Prophylactic CSD after primary ORIF for closed distal femur fractures not only had no significant advantage to minimize blood loss and wound complications, but increased local inflammation and postoperative hospital stay, and thus we suggest that prophylactic CSD after primary ORIF for closed distal femur fractures is not recommended for optimized clinical pathways and accelerated recovery.
Topics: Adult; Aged; Female; Femoral Fractures; Fracture Fixation, Internal; Humans; Male; Middle Aged; Open Fracture Reduction; Pain Measurement; Postoperative Complications; Prospective Studies; Suction; Unnecessary Procedures
PubMed: 33047488
DOI: 10.1111/os.12812 -
Acta Orthopaedica Et Traumatologica... 2011The aim of our study was to examine the effect of suction drains on knee after arthroscopic partial meniscectomy with partial fat pad removal or synovectomy. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
The aim of our study was to examine the effect of suction drains on knee after arthroscopic partial meniscectomy with partial fat pad removal or synovectomy.
METHODS
We performed arthroscopic partial meniscectomy for posterior tears of the medial meniscus and partial fat pad or synovium shaving in 72 patients. Following surgery, a suction drain was not used in 40 patients (Group A) and used in 32 (Group B). Both groups were similar in terms of age, gender, and total operation time. The patients were evaluated at 1, 2, and 4 weeks postoperatively for the presence of a knee effusion.
RESULTS
No significant difference was observed in the grade of effusion and the average percent change in the effusion grade between Groups A and B at 1, 2, and 4 weeks postoperatively.
CONCLUSION
Use of a suction drain did not influence the postoperative effusion or the clinical course of the effusion after arthroscopic partial meniscectomy with partial fat pad removal or synovectomy.
Topics: Adipose Tissue; Adult; Arthroscopy; Exudates and Transudates; Female; Humans; Knee Injuries; Male; Menisci, Tibial; Middle Aged; Suction; Synovectomy; Synovial Membrane; Tibial Meniscus Injuries; Treatment Outcome
PubMed: 21908960
DOI: 10.3944/AOTT.2011.2545 -
The Annals of Thoracic Surgery Sep 2003
Review
Topics: Heart Rupture; Heart Ventricles; Humans; Mediastinitis; Postoperative Complications; Sternum; Suction
PubMed: 12963251
DOI: 10.1016/s0003-4975(03)00180-2 -
Hepato-gastroenterology 2012Primary closure of the perineum along with drainage after abdominoperineal resection for lower rectal cancer is a widely accepted procedure but is associated with...
BACKGROUND/AIMS
Primary closure of the perineum along with drainage after abdominoperineal resection for lower rectal cancer is a widely accepted procedure but is associated with non-healing of the perineal wound a major complication. We evaluated the efficacy of omental packing and continuous suction drainage after abdominoperineal resection.
METHODOLOGY
We retrospectively studied 45 patients with adenocarcinoma of the lower rectum who underwent abdominoperineal resection, either without omental packing (NOP group) or with omental packing and continuous suction drainage (OPCD group). A pedicled omentum supplied by the epiploic arcade was conducted and drawn down through the perineal wound, over the small intestine and into the pelvis. Drains were placed on both sides of the pelvis through the perineal wall and continuous suction was performed.
RESULTS
Perineal wound infection was significantly more frequent in the NOP group (32%) than in the OPCD group (5%). Ileus was not observed in the OPCD group. The duration of hospitalization was shorter in the OPCD group (17.8±4.2 days) than in the NOP group (21.0±9.1 days).
CONCLUSIONS
Omental packing with continuous suction is useful to prevent non-healing of the perineal wound after abdominoperineal resection for lower rectal cancer.
Topics: Abdomen; Abdominal Wound Closure Techniques; Adenocarcinoma; Aged; Aged, 80 and over; Female; Humans; Length of Stay; Male; Middle Aged; Omentum; Perineum; Rectal Neoplasms; Retrospective Studies; Suction; Surgical Wound Infection; Time Factors; Treatment Outcome; Wound Healing
PubMed: 22353502
DOI: 10.5754/hge09325 -
Acta Orthopaedica Et Traumatologica... May 2017The purpose of this study was to evaluate the effect of late applied negative pressure on postoperative drain output after primary total hip arthroplasty (THA).
OBJECTIVE
The purpose of this study was to evaluate the effect of late applied negative pressure on postoperative drain output after primary total hip arthroplasty (THA).
PATIENTS AND METHODS
100 patients (100 hips) were treated by closed suction drainage applying negative pressure immediately after THA (group I). The remaining 100 patients (100 hips) were treated by the same drainage system, but the negative pressure was not applied in the first 24 h after THA and then negative pressure was applied (group II).
RESULTS
The mean total drain output was different between the two groups (group I: 597 ± 200.1 mL, group II: 403 ± 204.1 mL; p < 0.05). Reported drain output from immediate postoperative to postoperative day one was 369 ± 125.5 ml in group I and 221 ± 141.3 ml in group II (p < 0.05). The change of hemoglobin from immediate postoperative to 24 h after THA was lower in group II (group I: 1.5 ± 0.62 g/dL, group II: 1.1 ± 0.73 g/dL; p = 0.004). The mean unit number of blood transfusions was 1.0 (range, 0.0-5.0) in group I and 0.3 (range, 0.0-2.0) in group II (p < 0.05). There was no difference in Harris hip score between the two groups at postoperative 1 year or last follow-up (p = 0.073).
CONCLUSION
The minor change in drain system management can reduce postoperative blood loss after primary THA and the need for transfusion.
LEVEL OF EVIDENCE
Level III, Therapeutic study.
Topics: Adult; Arthroplasty, Replacement, Hip; Female; Femur Head Necrosis; Follow-Up Studies; Humans; Male; Middle Aged; Postoperative Care; Postoperative Complications; Postoperative Period; Practice Guidelines as Topic; Retrospective Studies; Suction
PubMed: 28336196
DOI: 10.1016/j.aott.2017.02.010 -
Journal of Gastrointestinal Surgery :... May 2021Post-operative pancreatic fistula (POPF) remains one of the most common complications after pancreatic surgery. We previously reported that the majority of US surgeons...
BACKGROUND
Post-operative pancreatic fistula (POPF) remains one of the most common complications after pancreatic surgery. We previously reported that the majority of US surgeons leave drains after pancreatectomy. However, there remains controversy and surgeon bias on the use of gravity compared with suction drainage with limited data on patient outcomes to guide management.
METHODS
Demographics, comorbidities, perioperative, and outcome data were captured from the most recent ACS National Surgical Quality Improvement Program (NSQIP)-targeted pancreatectomy databases. This is a retrospective cohort analysis comparing closed-suction to closed-gravity drains with multivariate analysis and propensity score matching (PSM).
RESULTS
Of 9232 patients that underwent a pancreatectomy with closed drain placement, 1345 (15%) were to gravity and 7887 (85%) were to suction. On multivariate and PSM, stratified by surgery-type, there was no difference in biochemical leak (Whipple, 4 vs. 4%; distal, 8 vs. 6%) or clinically relevant (CR)-POPF (Whipple, 13 vs. 15%; distal, 12 vs. 15%). On multivariate analysis, there was an increase in organ-space surgical site infections with suction drains for patients undergoing Whipple procedure (12 vs. 16%, p = 0.004), which did not persist on PSM (p = 0.088). Finally, there were no significant differences in amylase level, time to drain removal, or superficial surgical site infections for patients undergoing either procedure based on drain type.
CONCLUSION
The majority of drains utilized after pancreatectomy in the USA are placed to suction, though a significant proportion are kept to gravity. Neither type of drain is associated with increased CR-POPF or other post-operative outcomes compared with the other; therefore, both types remain reasonable options if drains are to be placed.
Topics: Drainage; Humans; Pancreatectomy; Pancreatic Fistula; Postoperative Complications; Propensity Score; Retrospective Studies; Suction
PubMed: 32394123
DOI: 10.1007/s11605-020-04613-7 -
The Journal of Maternal-fetal &... Sep 2021Intraperitoneal closed suction drains are occasionally placed during cesarean delivery. This study aims to ascertain the prevalence, associated factors, outcome, and...
INTRODUCTION
Intraperitoneal closed suction drains are occasionally placed during cesarean delivery. This study aims to ascertain the prevalence, associated factors, outcome, and risks of intraperitoneal closed-suction drain placed during cesarean delivery.
MATERIAL AND METHODS
A retrospective cohort study of all women undergoing cesarean delivery in a single center from 2005 to 2015. We excluded cases of cesarean hysterectomy and women who had hollow viscus injury. Cesarean deliveries were categorized into two groups based on intraperitoneal drain use: drain + and drain-.The study aims were to describe: (1) drain use prevalence; (2) factors associated with drain use; (3) interval to relaparotomy due to intraperitoneal bleeding and outcome of drain use; and (4) unique drain-related adverse outcome. Statistics: univariate, multivariable, and inverse probability treatment weighting (IPTW) analysis.
RESULTS
After applying the inclusion and exclusion criteria, 16 581 (99.3%) cesareans were included. An intraperitoneal drain was used in 1264 (7.6%) cesareans, ranging from 4.4 to 18.8% in women with no and four or more cesareans, respectively. Comparing the drain + and drain- groups, multivariable analysis revealed that the factors associated with the use of a drain included (OR, 95%CI) uterine rupture (5.14, 3.15-8.38), intrapartum fever (2.65, 1.87-3.75), previous cesareans (2.29, 2.00-2.68), second-stage cesarean (2.21, 1.64-2.74), preterm delivery (1.89, 1.63-2.19), spontaneous onset of labor (1.42, 1.24-1.63), and maternal age greater than 35 years (1.35, 1.19-1.54); < .001 for all. Of the forty-four women (0.27%) who underwent relaparotomy for intraperitoneal bleeding, there were fourteen in the intraperitoneal drain group. Inverse probability treatment weighting analysis demonstrated that median (interquartile range) times (hours) to relaparotomy were significantly shorter in the drain + group [3.5 (3.3-10.0) versus 12.5 (7.9-15.6), < .001] and that puerperal fever incidence was higher in the drain + group (2.2 vs. 1.4%, < .001). The incidence of relaparotomy to remove a retained drain or drain fragment was 0.48% (6/1264).
CONCLUSIONS
Drain use in our study resulted in a shorter time to relaparotomy for intraperitoneal hemorrhage. However, it was associated with a higher risk for puerperal fever and a 0.5% risk for relaparotomy for removal of the drain.KEY MESSAGEIntraperitoneal drain placed during cesarean is used more often in complicated surgeries and is associated with a shorter interval to relaparotomy.
Topics: Adult; Cesarean Section; Drainage; Female; Humans; Infant, Newborn; Pregnancy; Retrospective Studies; Suction; Uterine Rupture
PubMed: 31619122
DOI: 10.1080/14767058.2019.1677591 -
American Journal of Surgery Nov 1984A simple experimental study was designed to determine if closed suction drainage reduces the migration of pathogenic bacteria along a drain tract. Sixty New Zealand...
A simple experimental study was designed to determine if closed suction drainage reduces the migration of pathogenic bacteria along a drain tract. Sixty New Zealand rabbits, equally divided into three groups, were splenectomized through midline incisions. Group I served as the control group and received no drainage. Groups II and III had drainage of the splenic bed with simple latex conduit drains (Penrose drains) and closed suction drains (Jackson-Pratt drains), respectively. The skin near the drain exit site was inoculated with a Streptococcus organism. The animals were sacrificed after 72 hours, and intraperitoneal culture specimens were obtained. None of the control rabbits had positive cultures on intraperitoneal specimens. Eighteen of 20 rabbits (90 percent) in Group II (Penrose) had positive cultures on specimens from the splenic bed, whereas 75 percent had positive cultures on drain specimens. Only 4 of 20 (20 percent) of the Group III rabbits had positive cultures on the drain or splenic bed specimens. This difference was statistically significant by chi-square analysis (p less than 0.001). Retrograde migration of bacteria along a drain tract does occur with relatively high frequency with simple conduit drainage and is significantly less with closed suction drainage.
Topics: Animals; Drainage; Peritoneum; Rabbits; Skin; Streptococcal Infections; Suction; Surgical Wound Infection
PubMed: 6496851
DOI: 10.1016/0002-9610(84)90336-2 -
International Orthopaedics Mar 2016Several studies have failed to show significant benefits of closed suction drainage (CSD) in routine primary total hip arthroplasty (THA). However, blood loss, haematoma... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
Several studies have failed to show significant benefits of closed suction drainage (CSD) in routine primary total hip arthroplasty (THA). However, blood loss, haematoma formation and wound complications are generally much greater in revision THA as compared to primary THA. The purpose of this study was to determine if CSD is beneficial for revision THA patients.
METHODS
We conducted a prospective, randomized, controlled trial at our institution between July 2013 and July 2014. Eighty-eight patients undergoing revision THA were enrolled and randomly assigned to receive a CSD (n = 44) or to not receive a CSD (n = 44). All first-stage revision surgeries for infection were excluded. Primary outcomes were haemoglobin loss and number of patients transfused. Secondary outcomes included functional outcome evaluated with Harris hip score (HHS), pain evaluated with visual analogue scale (VAS), and length of hospital stay.
RESULTS
There were significantly more patients in the CSD group that required blood transfusions (20/44 as compared to 11/44, p = 0.04). Patients in the no CSD group were discharged earlier than patients in the CSD group (4.3 days as compared to 5.4 days, p = 0.002). No statistical significant difference was found in the HHS or pain VAS between the groups.
CONCLUSIONS
This study did not demonstrate any benefit with the use of CSD for revision THA with regard to wound related complications, infection or early functional outcome. Post-operative blood loss, transfusion rate, and length of hospital stay may be higher with CSD.
Topics: Adult; Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip; Blood Transfusion; Female; Humans; Length of Stay; Male; Middle Aged; Pain Measurement; Postoperative Hemorrhage; Prospective Studies; Reoperation; Suction
PubMed: 26278675
DOI: 10.1007/s00264-015-2960-y