- Email: [email protected]
A MODIFIED SUCTION DRAINAGE DEVICE
Methods In Medicine A MODIFIED SUCTION DRAINAGE DEVICE Maj N SRINATH* ABSTRACT
A simple modified suction drainage device made from Gibbon catheter and intravenous fluid glass bottle
is described. It is cheaper than the suction drains available in the market and useful to general surgeons in peripheral hospitals. . . MJAFI 1995; 51 : 51•52
KEYWORDS: Drainage; Suction.
Introduction he use of drains dates back to Hip› pocrates and Celsus, who described use of cannula. Heaton in 1898 first de› scribed use of constant suction drain [1]. The use of suction drains is now well established following many types of operating proce› dures. Being a closed and active drainage system, it minimises the entry of organisms into the body along the drains [1,2]. Suction drainage systems available in the market consist of drainage tubes made of PVC (12 FG size) with multiple perforations, an introducer, connecting tube and a container cum suction device in the form of either a compressible PVC bag (Romovac) costing Rs. 150/- per piece or a glass bottle with two antennae over the rubber stopper which move away from each other when negative pressure is created in the bottle (Redivac) costing Rs. 800/- per piece. They are usually not avail› able in all service hospitals. A simple modified suction drainage device utilising the materials freely available in most of the hospitals is described.
T
Material and Methods The modified suction drainage device has been made from a Gibbon catheter male size 12 FG or above, an old type intravenous fluid glass bottle with rubber stopper and two glass
rods which reach only a few em below the stopper and a suction apparatus. The portion of the Gibbon catheter in front of the flaps are used as suction drainage tube inside the body after additional holes as re› quired are cut carefully. with suture cutting scissors. The other end of the Gibbon catheter is fixed to one of the glass rods over sterilised glass bottle. The other glass rod is fitted with a small piece of red rubber tubing (Fig. 1). Once the operating procedure is com› pleted, a small haemostat is thrust from the depths of the wound through the layers of the body or abdomen slightly away from the main wound and the skin is tented. A small inci› sion is given over the tip of the haemostat and the tip is brought out. The tip of the Gibbon catheter is caught with the haemostat and pulled into the wound till the flaps touch the skin. A purse string suture or a piece of vase› line gauze may be wrapped around the cathe› ter if required. The flaps are cut so that only 3 cm of flaps are left on either side of the catheter and they can be strapped to theskin.. The other end of the Gibbon catheter is attached to the glass rod of the bottle. As soon as the main wound is closed, suction is ap› plied to the second glass tribe till a negative pressure of 500 mm of Hg is created in the bottle, Then the rubber tube is clamped and suction apparatus disconnected.
.. Classified Specialist (Surgery), Military Hospital. Belgaum - 590 009.
52 N SRINATII
MJAFI, 50 : 1, JANUARY 1995
purse string suture had to be put around the Gibbon catheter to make the exit wound airtight. TABLE 1 Use of modified suction drainage device in various op› erating procedures Operating procedure Thyroidectomy Sequestrectomy Patellectomy Tension band wiring patella Cholecystectomy Repair of incisional hernia Excision of gynaecomastia Superficial parotidectomy
No. of eases 2 2 2 3 3 6 2 1
Total
Fig. 1: Modified suction drainage device.
Once the patient is shifted to the ward, the .negative pressure is created again. After that the negative pressure is created 6 hours post operatively and 12 hourly thereafter. The drain is usually removed by 48 hours post operatively and if the drainage is more, till it is less than 10 ml per day. Observations The above device was used in 21 cases. The operation-wise distribution is as shown in Table 1. The suction drain functioned well in most of the cases. In two cases there was loss of .vacuum due to leakage from connection be› tween the catheter and bottle while shifting the patient. In one of the above patients it led to a Significant collection. In three cases, a•
Discussion A simple modified suction drainage device fabricated from materials usually available in all service hospitals and its successful use in a peripheral hospital is described. The advan› tage of this device is that it is cheap (Rs. 20/› per Gibbon catheter). It is easy to fix the Gibbon catheter because of the flaps. The connecting tube with additional connections is eliminated by the Gibbon catheter. Gibbon catheter has a radioopaque line and hence easily seen on radiographs. The main drawback. of the device is that it is not possible to know if the negative pres› sure is maintained in the bottle or not. This loss of vacuum accidentally can be avoided by careful shifting and nursing of the patient so as to avoid leakage and by frequently cre› ating the negative pressure in the bottle. REFERENCES 1. Sabiston DCJr. Textbook of Surgery. 13th ed., Phila› delphia: WB Saunders. 1986; 256-7. 2. Lobo .oN, Bose SM. A simple. cost-effective, closed gravity drainage device.lndianJ Surg 1994; 56: 31•2.
A simple modified suction drainage device made from Gibbon catheter and intravenous fluid glass bottle
is described. It is cheaper than the suction drains available in the market and useful to general surgeons in peripheral hospitals. . . MJAFI 1995; 51 : 51•52
KEYWORDS: Drainage; Suction.
Introduction he use of drains dates back to Hip› pocrates and Celsus, who described use of cannula. Heaton in 1898 first de› scribed use of constant suction drain [1]. The use of suction drains is now well established following many types of operating proce› dures. Being a closed and active drainage system, it minimises the entry of organisms into the body along the drains [1,2]. Suction drainage systems available in the market consist of drainage tubes made of PVC (12 FG size) with multiple perforations, an introducer, connecting tube and a container cum suction device in the form of either a compressible PVC bag (Romovac) costing Rs. 150/- per piece or a glass bottle with two antennae over the rubber stopper which move away from each other when negative pressure is created in the bottle (Redivac) costing Rs. 800/- per piece. They are usually not avail› able in all service hospitals. A simple modified suction drainage device utilising the materials freely available in most of the hospitals is described.
T
Material and Methods The modified suction drainage device has been made from a Gibbon catheter male size 12 FG or above, an old type intravenous fluid glass bottle with rubber stopper and two glass
rods which reach only a few em below the stopper and a suction apparatus. The portion of the Gibbon catheter in front of the flaps are used as suction drainage tube inside the body after additional holes as re› quired are cut carefully. with suture cutting scissors. The other end of the Gibbon catheter is fixed to one of the glass rods over sterilised glass bottle. The other glass rod is fitted with a small piece of red rubber tubing (Fig. 1). Once the operating procedure is com› pleted, a small haemostat is thrust from the depths of the wound through the layers of the body or abdomen slightly away from the main wound and the skin is tented. A small inci› sion is given over the tip of the haemostat and the tip is brought out. The tip of the Gibbon catheter is caught with the haemostat and pulled into the wound till the flaps touch the skin. A purse string suture or a piece of vase› line gauze may be wrapped around the cathe› ter if required. The flaps are cut so that only 3 cm of flaps are left on either side of the catheter and they can be strapped to theskin.. The other end of the Gibbon catheter is attached to the glass rod of the bottle. As soon as the main wound is closed, suction is ap› plied to the second glass tribe till a negative pressure of 500 mm of Hg is created in the bottle, Then the rubber tube is clamped and suction apparatus disconnected.
.. Classified Specialist (Surgery), Military Hospital. Belgaum - 590 009.
52 N SRINATII
MJAFI, 50 : 1, JANUARY 1995
purse string suture had to be put around the Gibbon catheter to make the exit wound airtight. TABLE 1 Use of modified suction drainage device in various op› erating procedures Operating procedure Thyroidectomy Sequestrectomy Patellectomy Tension band wiring patella Cholecystectomy Repair of incisional hernia Excision of gynaecomastia Superficial parotidectomy
No. of eases 2 2 2 3 3 6 2 1
Total
Fig. 1: Modified suction drainage device.
Once the patient is shifted to the ward, the .negative pressure is created again. After that the negative pressure is created 6 hours post operatively and 12 hourly thereafter. The drain is usually removed by 48 hours post operatively and if the drainage is more, till it is less than 10 ml per day. Observations The above device was used in 21 cases. The operation-wise distribution is as shown in Table 1. The suction drain functioned well in most of the cases. In two cases there was loss of .vacuum due to leakage from connection be› tween the catheter and bottle while shifting the patient. In one of the above patients it led to a Significant collection. In three cases, a•
Discussion A simple modified suction drainage device fabricated from materials usually available in all service hospitals and its successful use in a peripheral hospital is described. The advan› tage of this device is that it is cheap (Rs. 20/› per Gibbon catheter). It is easy to fix the Gibbon catheter because of the flaps. The connecting tube with additional connections is eliminated by the Gibbon catheter. Gibbon catheter has a radioopaque line and hence easily seen on radiographs. The main drawback. of the device is that it is not possible to know if the negative pres› sure is maintained in the bottle or not. This loss of vacuum accidentally can be avoided by careful shifting and nursing of the patient so as to avoid leakage and by frequently cre› ating the negative pressure in the bottle. REFERENCES 1. Sabiston DCJr. Textbook of Surgery. 13th ed., Phila› delphia: WB Saunders. 1986; 256-7. 2. Lobo .oN, Bose SM. A simple. cost-effective, closed gravity drainage device.lndianJ Surg 1994; 56: 31•2.