- Email: [email protected]
Continuous suction drainage in hand surgery
CLINICAL NOTE
Continuous suction drainage in hand surgery Paul A. Lunseth, M.D., Tampa, Fla., Richard I. Burton, M.D., Rochester, N. Y., and Richard M. Braun, M.D., San Diego, Calif.
The advantages of postoperative wound drainage for the prevention of hematomas are well known. 1- 6 Usually gauze or rubber drains are used with supportive dressings, but many surgeons believe that continuous From the Section of Orthopaedic Surgery and Hand Surgery, University of South Florida School of Medicine, Tampa, Fla., the Department of Orthopaedic Surgery, University of Rochester Medical Center, Rochester, N.Y., and Hillcrest Orthopaedic Medical Group, San Diego, Calif. Received for publication May 9, 1978. Revised for publication July II, 1978. Reprint requests: Paul A. Lunseth, M.D., 4600 N. Habana, Suite 35, Tampa, FL 33614.
suction drainage under the skin flaps can further reduce the risk of hematoma. 2 • 7 • 8 A simple, effective, and inexpensive method of providing continuous suction for small wounds or skin flaps in the hand is to use a prepackaged, sterile 19 polyethylene catheter with attached butterfly needle (Fig. 1). The connector end is cut off and discarded, and the tube is placed under the skin through a small puncture wound nearby. The dressing then is applied with the catheter portion positioned proximally. After the tourniquet is released, the needle is passed through the rubber stopper of the standard laboratory vacutanor tube used for the collection of blood samples (Fig. 2).
0 Fig. 1. The connector portion of the 19 gauge infusion set (Abbot butterfly (No. 4590) 19 gauge by % inch infusion set was used) has been cut off and will be discarded. The sterile needle and polyethylene catheter are supplied in a prepackaged container. Fig. 2. The polyeylene tube has been passed through a small skin puncture wound and placed under the wound flap. Wound closure has been accomplished, and a sterile supportive hand dressing is applied. The vacutanor tube is applied prior to the release of the tourniquet for continuous wound suction drainage.
0363-5023/79/020193+02$00.20/0 © 1979 American Society for Surgery of the Hand
THE JOURNAL OF HAND SURGERY
193
194
Lunseth, Burton, Braun
An anticoagulant is in the vial. The tubing can be removed from the wound without disturbing the supportive dressing. This method has been used in more than 200 patients without evidence of skin slough, wound infection, or significant hematoma formation.
REFERENCES l. Buchanan JM, Lambley DG: The advantages of wound suction drainage in general surgery. J Int Coli Surg 34:701' 1960 2. Burton RI, Littler JW: Nontraumatic soft tissue afflictions of the hand. Curr Prob Surg Jul 1975, 1-56 3. Connolly JE: Prevention of postoperative subcutaneous fluid collection by suction. JAMA 157:1490, 1955
The Journal of HAND SURGERY
4. McCash CR: The open palm technique in Dupuytren's contracture. Br J Plast Surg 17:271, 1964 5. McFarlane RM: Use of continuous suction after operation for Dupuytren's contracture. Br J Plast Surg 11:301, 1959 6. Waugh TR, Stinchfield FE: Suction drainage of orthopaedic wounds. J Bone Joint Surg [Am] 43a;939, 1961 7. Linton AW, Graham WP III In Kilgore ES Jr, Graham WP III, editors: The hand, Philadelphia, 1977, Lea & Febiger, Publishers pp 63-6 8. Miller SH, Schantz J, Davis T, Graham WP: An inexpensive wound suction device. Surg Gynecol Obstet 141:768, 1975 9. Thompson JS, Littler JW: Dressings and splints, in Converse JM: editor: Reconstructive and plastic surgery, vol 6, Philadelphia, 1977, WB Saunders Co, pp 2991
COPYRIGHT INFORMATION The appearance of a code at the bottom of the first page of an original article in this JouRNAL indicates the copyright owner's consent that copies of the article may be made for personal or internal use, or for the personal or internal use of specific clients. This consent is given on the condition, however, that the copier pay the stated per copy fee through the Copyright Clearance Center, Inc., P. 0. Box 765, Schenectady, NY 12301, 518-374-4430, for copying beyond that permitted by Sections 107 or 108 of the U.S. Copyright Law. This consent does not extend to other kinds of copying, such as copying for general distribution, for advertising or promotional purposes, for creating new collective works, or for resale.
Continuous suction drainage in hand surgery Paul A. Lunseth, M.D., Tampa, Fla., Richard I. Burton, M.D., Rochester, N. Y., and Richard M. Braun, M.D., San Diego, Calif.
The advantages of postoperative wound drainage for the prevention of hematomas are well known. 1- 6 Usually gauze or rubber drains are used with supportive dressings, but many surgeons believe that continuous From the Section of Orthopaedic Surgery and Hand Surgery, University of South Florida School of Medicine, Tampa, Fla., the Department of Orthopaedic Surgery, University of Rochester Medical Center, Rochester, N.Y., and Hillcrest Orthopaedic Medical Group, San Diego, Calif. Received for publication May 9, 1978. Revised for publication July II, 1978. Reprint requests: Paul A. Lunseth, M.D., 4600 N. Habana, Suite 35, Tampa, FL 33614.
suction drainage under the skin flaps can further reduce the risk of hematoma. 2 • 7 • 8 A simple, effective, and inexpensive method of providing continuous suction for small wounds or skin flaps in the hand is to use a prepackaged, sterile 19 polyethylene catheter with attached butterfly needle (Fig. 1). The connector end is cut off and discarded, and the tube is placed under the skin through a small puncture wound nearby. The dressing then is applied with the catheter portion positioned proximally. After the tourniquet is released, the needle is passed through the rubber stopper of the standard laboratory vacutanor tube used for the collection of blood samples (Fig. 2).
0 Fig. 1. The connector portion of the 19 gauge infusion set (Abbot butterfly (No. 4590) 19 gauge by % inch infusion set was used) has been cut off and will be discarded. The sterile needle and polyethylene catheter are supplied in a prepackaged container. Fig. 2. The polyeylene tube has been passed through a small skin puncture wound and placed under the wound flap. Wound closure has been accomplished, and a sterile supportive hand dressing is applied. The vacutanor tube is applied prior to the release of the tourniquet for continuous wound suction drainage.
0363-5023/79/020193+02$00.20/0 © 1979 American Society for Surgery of the Hand
THE JOURNAL OF HAND SURGERY
193
194
Lunseth, Burton, Braun
An anticoagulant is in the vial. The tubing can be removed from the wound without disturbing the supportive dressing. This method has been used in more than 200 patients without evidence of skin slough, wound infection, or significant hematoma formation.
REFERENCES l. Buchanan JM, Lambley DG: The advantages of wound suction drainage in general surgery. J Int Coli Surg 34:701' 1960 2. Burton RI, Littler JW: Nontraumatic soft tissue afflictions of the hand. Curr Prob Surg Jul 1975, 1-56 3. Connolly JE: Prevention of postoperative subcutaneous fluid collection by suction. JAMA 157:1490, 1955
The Journal of HAND SURGERY
4. McCash CR: The open palm technique in Dupuytren's contracture. Br J Plast Surg 17:271, 1964 5. McFarlane RM: Use of continuous suction after operation for Dupuytren's contracture. Br J Plast Surg 11:301, 1959 6. Waugh TR, Stinchfield FE: Suction drainage of orthopaedic wounds. J Bone Joint Surg [Am] 43a;939, 1961 7. Linton AW, Graham WP III In Kilgore ES Jr, Graham WP III, editors: The hand, Philadelphia, 1977, Lea & Febiger, Publishers pp 63-6 8. Miller SH, Schantz J, Davis T, Graham WP: An inexpensive wound suction device. Surg Gynecol Obstet 141:768, 1975 9. Thompson JS, Littler JW: Dressings and splints, in Converse JM: editor: Reconstructive and plastic surgery, vol 6, Philadelphia, 1977, WB Saunders Co, pp 2991
COPYRIGHT INFORMATION The appearance of a code at the bottom of the first page of an original article in this JouRNAL indicates the copyright owner's consent that copies of the article may be made for personal or internal use, or for the personal or internal use of specific clients. This consent is given on the condition, however, that the copier pay the stated per copy fee through the Copyright Clearance Center, Inc., P. 0. Box 765, Schenectady, NY 12301, 518-374-4430, for copying beyond that permitted by Sections 107 or 108 of the U.S. Copyright Law. This consent does not extend to other kinds of copying, such as copying for general distribution, for advertising or promotional purposes, for creating new collective works, or for resale.