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Surgery Today Apr 2021The purpose of this study was to evaluate the effectiveness of a wound closure method using a combination of subcuticular sutures and subcutaneous closed-suction...
PURPOSE
The purpose of this study was to evaluate the effectiveness of a wound closure method using a combination of subcuticular sutures and subcutaneous closed-suction drainage (SS closure) for preventing incisional surgical site infection (SSI) in loop ileostomy closure.
METHODS
A total of 178 consecutive patients who underwent loop ileostomy closure at Nara Medical University Hospital between 2004 and 2018 were retrospectively assessed. The patients were divided into 2 groups: the conventional skin closure (CC) group from 2004 to 2009 (75 patients) and the SS closure (SS) group from 2010 to 2018 (103 patients). The incidence of incisional SSI was compared between the two groups, and the factors associated with incisional SSI were examined by univariate and multivariate analyses.
RESULTS
Incisional SSI occurred in 7 cases (9.3%) in the CC group but was significantly reduced to only 1 case (0.9%) in the SS group (p = 0.034). In the univariate analysis, the hemoglobin levels, serum creatinine levels, and SS closure were associated with incisional SSI. SS closure was the only independent preventive factor for incisional SSI according to the multivariate analysis (hazard ratio = 0.24, p = 0.011).
CONCLUSION
The combination of subcuticular sutures and subcutaneous closed-suction drainage may be a promising way of preventing incisional SSI in loop ileostomy closure.
Topics: Biomarkers; Creatine; Female; Hemoglobins; Humans; Ileostomy; Male; Retrospective Studies; Risk; Suction; Surgical Wound Infection; Suture Techniques; Sutures; Treatment Outcome; Wound Closure Techniques
PubMed: 32888080
DOI: 10.1007/s00595-020-02128-x -
Journal of Hepato-biliary-pancreatic... 2009Pancreaticojejunal anastomotic leakage remains a major complication after pancreatoduodenectomy, and various means of preventing pancreatic leakage have been studied... (Comparative Study)
Comparative Study Randomized Controlled Trial
BACKGROUND
Pancreaticojejunal anastomotic leakage remains a major complication after pancreatoduodenectomy, and various means of preventing pancreatic leakage have been studied over the past few decades. The purpose of this study was to determine whether closed suction drainage provided a better option than gravity drainage in pancreaticojejunostomy.
METHODS
Between 2004 and 2006, a total of 110 patients who underwent pancreaticojejunostomy at our institute were enrolled in this prospective randomized pilot study. Fifty-five patients were allocated to the closed suction drainage (CD) group and 55 to the gravity drainage (GD) group. In each patient a polyethylene pediatric feeding tube was inserted into the remnant pancreatic duct across a duct-to-mucosa type pancreaticojejunostomy and totally externalized. The tube was then connected to the aspiration bag of a Jackson-Pratt drain to generate negative pressure or to a bile bag for natural drainage. Pancreatic fistulas were defined and graded as A, B, or C according to the international study group for pancreatic fistulas (ISGPF) criteria.
RESULTS
No differences were found between the GD and CD groups in age, sex distribution, or diagnosis. A pancreatic fistula occurred in 24 patients (43.6%) in the GD group and in 14 (25.5%) in the CD group (P = 0.045). In the GD group, grade B and C fistula occurred in 6 patients (10.9%), whereas in the CD group, this occurred in 5 patients (9.1%).
CONCLUSION
In this study, temporary external drainage of the pancreatic duct with closed suction drainage significantly reduced the incidence of grade A pancreatic fistula. A follow-up randomized prospective multicenter study has been initiated.
Topics: Aged; Drainage; Female; Humans; Male; Middle Aged; Pancreatic Ducts; Pancreatic Fistula; Pancreaticojejunostomy; Pilot Projects; Prospective Studies; Suction
PubMed: 19730769
DOI: 10.1007/s00534-009-0171-x -
Revista de Enfermeria (Barcelona, Spain) Jun 2007Pleural pathology is a frequent clinical problem. In some cases, treatment includes draining the cavity which can be carried out by thoracentesis evacuators, but on...
Pleural pathology is a frequent clinical problem. In some cases, treatment includes draining the cavity which can be carried out by thoracentesis evacuators, but on occasions treatment requires maintaining a drainage permanently inside the pleural cavity Pleural drainage consists in inserting a catheter in the pleural sack to drain the presence of air; liquid or blood which causes a variable degree of lung collapse having a clinical consequence in function of the reserve breathing capacity the patient previously had and the degree of collapse. There are various models of thoracic tubes as well as systems to drain the pleural cavity and their spot for insertion depends on the type of pathology being dealt with for the patient under treatment. Nursing is fundamental in this entire process, including in the preparation of the patient for this treatment, the insertion of the catheter and the adequate maintenance so that this procedure succeeds as well as during the removal of the catheter and the subsequent care required. It is fundamental that the nursing professionals know the materials used as well as their maintenance. A good technique to cure the punt/orifice where a catheter is inserted will prevent numerous complications which could be deadly for the patient. The authors create a procedural protocol for nurses to use when treating patients who have thoracic drains; this protocol deals with changing the catheters as well as the entire process related to how to treat patients with a pleural drain. This protocol should serve as reference material and as a guide to a systematic and homogenous working procedure.
Topics: Equipment Design; Humans; Pleural Effusion; Suction; Thoracic Cavity
PubMed: 17685144
DOI: No ID Found -
Journal of Oral and Maxillofacial... Jun 1993Intraoral or extraoral closed suction drainage was used following the surgical enucleation of 42 jaw cysts. Primary healing was observed in 38 (90%) of the patients and...
Intraoral or extraoral closed suction drainage was used following the surgical enucleation of 42 jaw cysts. Primary healing was observed in 38 (90%) of the patients and complete osseous regeneration was achieved in 17 of 30 patients. In the remaining patients, a slight loss in width and height of the involved area occurred. No functional disturbances were caused by these bony reductions.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bone Regeneration; Humans; Mandibular Diseases; Middle Aged; Odontogenic Cysts; Postoperative Care; Suction; Treatment Outcome
PubMed: 8492198
DOI: 10.1016/s0278-2391(10)80260-5 -
Gynecologic Oncology May 1995Over a 7-year period from 1987 to 1994, 120 patients consecutive patients with FIGO stage IB invasive cervical cancer who underwent type 3 radical abdominal hysterectomy... (Clinical Trial)
Clinical Trial Comparative Study
Over a 7-year period from 1987 to 1994, 120 patients consecutive patients with FIGO stage IB invasive cervical cancer who underwent type 3 radical abdominal hysterectomy and bilateral pelvic lymphadenectomy had either Jackson-Pratt closed-suction drainage (Group 1, patients 1-60) or no drainage (Group 2, patients 61-120). All surgeries were performed by the author in a uniform manner. No increase in postoperative pelvic infection, fistula, or lymphocyst formation was noted in the group of patients with no drainage following radical hysterectomy and lymphadenectomy. Routine closed-suction drainage following radical hysterectomy and pelvic lymphadenectomy may be safely omitted.
Topics: Adult; Female; Humans; Hysterectomy; Lymph Node Excision; Middle Aged; Neoplasm Staging; Pelvis; Prospective Studies; Suction; Uterine Cervical Neoplasms
PubMed: 7729740
DOI: 10.1006/gyno.1995.1131 -
Journal of Plastic, Reconstructive &... Sep 2021
Letter comments on: "A comparison of the efficacy of autologous fibrin glue/platelet-poor plasma versus suction drainage in preventing hematoma and seroma in rhytidectomy: A randomized, double-blind, controlled study".
Topics: Double-Blind Method; Fibrin Tissue Adhesive; Hematoma; Humans; Rhytidoplasty; Seroma; Suction
PubMed: 34330675
DOI: 10.1016/j.bjps.2021.05.075 -
Thoracic Surgery Clinics Feb 2017There is scant evidence on the management of chest tubes after surgery for pneumothorax. Most of the current knowledge is extrapolated from studies performed on subjects... (Review)
Review
There is scant evidence on the management of chest tubes after surgery for pneumothorax. Most of the current knowledge is extrapolated from studies performed on subjects with lung cancer. This article reviews the existing literature with particular focus on the effect of suction and no suction on the duration of air leak after lung resection and surgery for pneumothorax. Moreover, the role of regulated suction, which seems to provide some benefit in reducing pneumothorax recurrence after bullectomy and pleurodesis, is discussed. Finally, a personal view on the management of chest tubes after surgery for pneumothorax is provided.
Topics: Chest Tubes; Humans; Lung; Pleurodesis; Pneumothorax; Postoperative Care; Suction
PubMed: 27865323
DOI: 10.1016/j.thorsurg.2016.08.004 -
Tropical Doctor Jul 1998
Topics: Humans; Postoperative Care; Suction; Wounds and Injuries
PubMed: 9700290
DOI: 10.1177/004947559802800321 -
Journal of Cardiac Surgery Jul 2020A new, self-contained, digital, continuous pump-driven chest drainage system is compared in a randomized control trial to a traditional wall-suction system in cardiac... (Comparative Study)
Comparative Study Randomized Controlled Trial
BACKGROUND
A new, self-contained, digital, continuous pump-driven chest drainage system is compared in a randomized control trial to a traditional wall-suction system in cardiac surgery.
METHODS
One hundred and twenty adult elective cardiac patients undergoing coronary artery bypass graft and/or valve surgery were randomized to the study or control group. Both groups had similar pre/intra-operative demographics: age 67.8 vs 67.0 years, Euroscore 2.3 vs 2.2, and body surface area 1.92 vs 1.91 m . Additionally, a satisfaction assessment score (0-10) was performed by 52 staff members.
RESULTS
Given homogenous intra-operative variables, total chest-tube drainage was comparable among groups (566 vs 640 mL; ns), but the study group showed more efficient fluid collection during the early postoperative phase due to continuous suction (P = .01). Blood, cell saver transfusions and postoperative hemoglobin values were similar in both groups. The study group experienced drain removal after 29.8 vs 38.4 hours in the control group (ns). Seven crossovers from the Study to the Control group were registered but no patient had drain-related complications. The Personnel Satisfaction Assessment scored above 5 for all questions asked.
CONCLUSIONS
The new, digital, chest drainage system showed better early drainage of the chest cavity and was as reliable as conventional systems. Quicker drain removal might impact on intensive care unit (ICU) stay and reduce costs. Additional advantages are portable size, battery operation, patient mobility, noiseless function, digital indications and alarms. The satisfaction assessment of the new system by the staff revealed a higher score when compared to the traditional wall suction chest drainage system.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Coronary Artery Bypass; Cost Savings; Female; Heart Valves; Humans; Length of Stay; Male; Middle Aged; Outcome Assessment, Health Care; Postoperative Care; Safety; Suction; Thoracic Cavity; Young Adult
PubMed: 32436655
DOI: 10.1111/jocs.14629 -
The Journal of Bone and Joint Surgery.... Nov 1978A prospective trial has been carried out to determine the value of suction drainage in the operation of meniscectomy. One hundred operations were analysed, in half of... (Clinical Trial)
Clinical Trial
A prospective trial has been carried out to determine the value of suction drainage in the operation of meniscectomy. One hundred operations were analysed, in half of which drains had been used. The use of the drain could not be shown to result in any sustained advantages. The demand for analgesics after the operation was reduced but not to a statistically significant level. The size of the early effusion was significantly reduced, but this benefit was lost when the knee was mobilised. The return of power to the quadriceps and of movement to the knee were not hastened. The average volume of fluid drained was 134 millilitres and it has been shown that forty-eight hours is a suitable time for removal of the drain. The use of suction drainage is not advocated for the uncomplicated operation of meniscectomy.
Topics: Cartilage, Articular; Exudates and Transudates; Female; Humans; Knee Joint; Leg; Male; Movement; Pain, Postoperative; Postoperative Complications; Prospective Studies; Suction
PubMed: 711799
DOI: 10.1302/0301-620X.60B4.711799