Flutter valve drainage bag is a useful device for the pleural drainage

BACKGROUND AND AIMS: The purpose of the present study was to compare the use of the flutter valve pleural drainage bag and the conventional underwater seal system for the pleural drainage in the treatment of pneumothorax and pleural effusion. PATIENTS AND METHODS: Altogether fifty patients who needed the pleural drainage at our hospital between February and October 1999 were randomized to this prospective study either into the flutter valve pleural drainage group or into the conventional underwater seal pleural drainage group, 25 patients in each. RESULTS: In the conventional underwater seal system group, the mean drainage time was 4.1 (SD +/- 4.0) days and in the flutter valve drainage bag group 4.8 (SD +/- 4.9) days (difference -0.7, 95% confidence interval (CI) -3.3 to 1.8). The mean length of hospitalization was 16.3 (SD +/- 20.9) days and 18.7 (SD +/- 27.0) respectively (difference -2.4, 95% CI -16.1 to 11.3). CONCLUSIONS: The results of this study suggest that flutter valve drainage bag is a safe and feasible system in the most cases when pleural drainage is needed in the treatment of pneumothorax and pleural effusion.     

Comparison between flutter valve drainage bag and underwater seal device for pleural drainage after lung surgery.

AIM OF THE STUDY: The purpose of the present study was to compare the use of a conventional underwater seal device with suction and a flutter valve drainage bag for pleural drainage after lung surgery. PATIENTS AND METHODS: Altogether 59 patients undergoing elective lung surgery except pneumonectomy between February 2001 and April 2002 were prospectively randomized to receive postoperative pleural drainage by 28F chest tube(s) attached to underwater seal device placed on negative pressure of 15 cm of water or flutter valve drainage bag. Following withdrawal of four patients from the study, 55 patients were evaluated (31 patients in the underwater seal device group and 24 patients in the flutter valve drainage bag group). RESULTS: In the conventional underwater seal device group the mean drainage time was 2.6 (SD +/- 2.0) days and in the flutter valve drainage bag group the mean drainage time was 3.3 days (SD +/- 4.0); difference -0.8, 95% confidence interval (CI) -2.4 to 0.9. The mean length of hospitalization in the surgical ward was 3.6 (SD +/- 2.7) and 4.1 (SD +/- 4.4) days respectively (difference -0.5, 95% CI -2.5 to 1.4). CONCLUSIONS: The results of this study suggest that flutter valve drainage system is a safe and feasible alternative in managing postoperative air leaks and haemorrhage after lung surgery other than pneumonectomy if air leaks are not extremely massive.     

Evaluation of varicocele by ultrasonography through a water bag in the supine position

Recently, ultrasonography has been widely used to evaluate varicocele. However, it is difficult to obtain reproducible scrotal images with a hand probe in the standing position. We, therefore, applied the water bag technique during ultrasonographic examination of the scrotal contents in the supine position. The ultrasonographic images thus obtained were compared with physical findings and scrotal scintigraphic findings. Forty-five varicocele patients diagnosed by palpation and ultrasonography were enrolled in this study. An ultrasonographic examination through a water bag in the supine position has the following advantages 1) it is easy to perform and stable images are obtained, 2) varicoceles that are not palpable can be detected and 3) examinations can be repeated both pre- and postoperatively. Of the 45 patients, 39 and 41 had positive findings on the ultrasonographic images and physical examinations, respectively. Four patients had negative findings on physical examination but positive findings on the ultrasonographic images. Thus, ultrasonographic images through a water bag in the supine position proved to be a useful method of confirming the hemodynamics in varicoceles.     

Indwelling urinary catheter infections in small community hospital. Role of urinary drainage bag

Ninety cases of closed drainage urinary catheterization were studied by daily bacteriologic monitoring with Microstix. In 23 per cent of the patients bacteriuria developed, and 92.6 per cent of all catheter infections occurred within three days. These infections occurred primarily in postsurgical patients, and were probably related to initial contamination during catheter insertion. Only 1 patient had a positive drainage bag urine culture prior to the development of bladder bacteriuria. At our institution poor catheter technique was much more important as a risk factor of nosocomial urinary tract infection than an antiseptic drainage bag system.     

Splenic retrieval after laparoscopic splenectomy: a new bag

BACKGROUND: Laparoscopic splenectomy has become the gold-standard surgical approach for patients undergoing elective splenectomy. Little data exist concerning the technical difficulties of splenic retrieval. When the spleen is large, popular commercial retrieval bags are often too small to facilitate removal. The aim of this study was to compare our clinical experience utilizing two different retrieval bags, the Endocatch II (Autosuture, London, UK) and the developing E200 (Espiner Ltd., Bristol, UK). MATERIALS AND METHODS: We performed a retrospective review of all laparoscopic splenectomies performed at Hull Royal Infirmary, Kingston upon Hull, from March 1997 to July 2003. Patient demographics, morbidity, mortality, and clinical outcome had been entered prospectively into a database. Two patient groups were examined, depending on the type of retrieval bag utilized. Complications and instrument failure during splenic retrieval were analysed. RESULTS: A total of 83 laparoscopic splenectomies were performed. No retrieval bag was used in 8 cases (10%). The Endocatch retrieval bag was used for 45 (60%) patients and the E200 for 30 (40%) patients. The mean operative time for the former group was 65 minutes (range, 50-127 minutes) and for the latter, 120 minutes (range, 80-180 minutes) (P < 0.05). Bag-related complications were 2 (4%) perforations and 2 (4%) failures to deploy while using the Endocatch bag. CONCLUSION: The Endocatch bag is easy to deploy but is associated with perforation and cannot be used for large spleens. The E200 bag is more useful for large spleens but is associated with prolonged operative time due to poor maneuverability. Improved technology is still required.     

A simple method of implantation within the capsular bag

We describe a new method of implantation in the capsular bag. The initial anterior capsulotomy incision is limited to a linear opening from 10 o'clock to 2 o'clock. The nucleus is expressed and the cortical remnants are removed. An implant, specially designed for this technique, is introduced vertically between anterior and posterior capsules and then rotated to a horizontal position entirely within the capsular bag. Finally, a central piece of anterior capsule is excised.     

Blunt liver trauma from bean bag ammunition

Police departments in Europe are increasingly using nonlethal weapons and/or ammunitions such as a bean bag to restrain and disable a person temporarily. A bean bag is a small nylon bag filled with metal balls that is fired from a shotgun and weighs approximately 50 g. It is successfully used in the United States by law enforcement personnel. This report describes a case in which use of a bean bag resulted in a contusion of the liver, which was treated conservatively.     

Purple urine bag syndrome: A rare clinical entity in patients with long term indwelling catheters

An elderly gentleman, on urinary drainage catheter for 3 months developed a purple discoloration of the urinary bag with the urine inside remaining clear. He was found to have a urinary tract infection with a strain of E. coli manifesting as a rare clinical entity reported in literature as the “Purple urine bag syndrome”.     

Laparoscopic splenectomy for massive splenomegaly using a Lahey bag

BACKGROUND: Although the recent development of hand-assisted laparoscopic surgery (HALS) has made the laparoscopic retraction of large spleens feasible, the laparoscopic removal of massively enlarged spleens (>1,000 g) remains a significant problem because these spleens do not fit into endoscopic bags. Consequently, in order to remove massive spleens either a large abdominal incision or morcellation of the spleen outside of an endoscopy bag is required. METHODS: Two patients, with spleens weighing 2,510 g and 1,720 g, underwent laparoscopic splenectomy using a hand port to ensure safe retraction. The massive spleen was placed into a Lahey bag that was inserted into the abdomen through the hand port site. While in the Lahey bag, the spleen was removed piecemeal through the hand port site. RESULTS: Both operations were completed laparoscopically without complications. The patients were discharged on postoperative day 2 and experienced minimal morbidity. CONCLUSIONS: The Lahey bag facilitates laparoscopic splenectomy for massive splenomegaly as even the most massive spleens will fit into a Lahey bag. A massive spleen may be removed piecemeal from the Lahey bag through the small hand port incision without risking a large abdominal incision, splenosis, or the insertion of a morcellator.     

Tunneled lumbar drain. Technical note

The authors report a simple and rapid procedure for tunneling a lumbar drain subcutaneously to facilitate chronic cerebrospinal fluid (CSF) drainage. A standard lumbar puncture (LP) is performed with a large-bore Tuohy needle (14- to 16-gauge), the drainage catheter is advanced into the subarachnoid space, and the needle is removed. The free Tuohy needle is then passed from a lateral position and brought out through the initial LP site. The free catheter is fed through the needle, and the needle is removed. The drain is attached to an external drainage bag in the usual manner. The authors have found this method particularly useful in some skull base and spinal surgical applications in which longer term continuous CSF drainage is desired.     

Ascaris worm in the intercostal drainage bag: inadvertent intercostal tube insertion into jejunum: a case report

Inadvertent insertion of the intercostal tube into abdomen is not rare. It can present by different ways. In the present case an Ascaris worm crept into the intercostal drainage bag to reveal the false passage of the tube.     

立体多向眼袋整形术

目的　探讨继发性眼袋的病因并寻找更为有效合理的手术方法。方法　矢状面上将皮肤、眼轮匝肌分层切除、提紧，疝出的眶脂部分切除或眶缘释放；冠状面上将皮肤纵横双向提紧，肌层星形切除缝合，双向提紧。结果　64例中63例效果满意。结论　立体多向眼袋整形术是针对眼袋的发生机理而设计，可获良好效果。     

立体多向眼袋整形术

目的　探讨继发性眼袋的病因并寻找更为有效合理的手术方法。方法　矢状面上将皮肤、眼轮匝肌分层切除、提紧 ,疝出的眶脂部分切除或眶缘释放 ;冠状面上将皮肤纵横双向提紧 ,肌层星形切除缝合 ,双向提紧。结果　 6 4例中 6 3例效果满意。结论　立体多向眼袋整形术是针对眼袋的发生机理而设计 ,可获良好效果     

Unitary drainage bag

A urinary bag in which the collection bag is part of a panel that hangs from a belt around the patient's waist avoids local irritation of the thigh and embarrassment of the superficial venous circulation. The bag can be used with nephrostomy and cystostomy tubes as well as urethral catheters.     

Comparing sterile bag rubbing and paint on technique in skin preparation of the hands

Background: The aim of this study was to compare two techniques for surgical site skin preparation in hand surgery. Methods: We compared the standard sponge paint technique versus a plastic bag immersion technique using a 10% povidone–iodine with alcohol solution (Betadine, ORION Laboratories Pty Ltd, Balcatta, WA, Australia) to prepare surgical site skin for hand surgery. This sterile bag rubbing technique involves using a sterile plastic bag filled with 60 mL of Betadine solution to immerse the subjects' hand. Samples were taken from 10 subjects for bacteria colony‐forming unit (CFU) counts before and 3 min after surgical site preparation in each group. Outcome measures were preparation time and CFU reduction with a plate impression test using commercially available agar slides. Results: The sterile bag rubbing technique significantly reduced (P < 0.0001) the time required for surgical site skin preparation (28 s) compared with the standard technique (86 s). Both techniques were found to have similar efficacy in the reduction of CFU. Conclusions: The sterile bag rubbing technique is a quicker alternative method for surgical site preparation in hand surgery and has comparable efficacy to the widely practised standard paint‐on technique.     

集尿袋更换频率与泌尿外科患儿尿路感染相关性分析

目的：探讨泌尿外科患儿集尿袋更换频率与尿路感染的相关性以及护理预防对策,从而确定更换患儿集尿袋的最佳频率,降低尿路感染的风险,提高护理质量。方法将82例留置导尿的泌尿外科患儿随机分为试验组和对照组,各41例。试验组患儿集尿袋更换频率为1次/周,对照组患儿集尿袋更换频率为1次/d,追踪监测尿培养,比较分析两组患儿采用不同频率更换集尿袋与尿路感染的发生率之间的关系。结果与对照组相比,试验组在特定时间内尿培养检出阳性例数明显低于对照组,阳性率明显偏低,差异显著（P ＜0.05）。结论选择适当的集尿袋更换频率能够减少污染的机会,降低尿路感染的发生率,有利于提高护理质量,临床上集尿袋更换频率以每周1次较为有效。     

睑袋的分型与手术方式的选择

目的探讨睑袋分型与手术方式选择的关系,以及临床效果。方法根据临床表现将216例睑袋分为3型和7个亚型,I型以先天结构异常为主要原因,Ⅱ型以长期用眼疲劳为主要原因,Ⅲ型以组织及骨的退行性变化为主要原因。按分型进行手术,手术方法按亚型设定7种。结果216例中159例获得随访3～12个月,均取得较好的临床效果。结论此分型简单,对临床手术方法的选择有很好的指导意义。     

自制标本袋在腹腔镜卵巢肿瘤手术中的应用

目的 :探讨自制标本袋在腹腔镜卵巢肿瘤手术中的应用价值。方法 :应用电视腹腔镜技术及自制的标本袋为 12 0例卵巢肿瘤患者施术 (腹腔镜卵巢肿瘤挖出术 112例 ,附件切除术 8例 )。结果 :手术时间平均 70min ,与未用标本袋的同类手术相比 ,手术时间缩短 (P <0 0 5 ) ;术后平均 2 4h患者胃肠功能恢复 ;术中平均出血 4 0ml ;4～ 6d出院。 2例发生轻微皮下气肿 ,无术后出血及腹膜炎发生。结论 :妇科腹腔镜手术使用自制标本袋有效地减低了腹腔及切口污染 ,减少了并发症的发生 ,缩短了手术时间     

3升生理氯化钠溶液袋暂时性关腹的临床应用

目的探讨腹腔严重感染病人应用3升生理氯化钠溶液袋暂时性关腹技术的价值。方法回顾性分析2007年9月至2009年1月间7例严重腹腔感染应用3升生理氯化钠溶液袋暂时性关腹,观察治疗效果、预后。结果本组痊愈5例,无严重并发症出现,多器官功能衰竭死亡1例,放弃治疗1例。结论3升生理氯化钠溶液袋暂时性关腹技术是一种价格低廉、有效的特殊情况时使用的暂时性关腹手段。     

真空垫在CT引导下肺部穿刺活检中的应用

目的探讨真空垫固定在CT引导下肺部穿刺活检中的应用价值。方法从1256例接受CT引导下肺部穿刺活检的患者中随机选取120例,分为2组：A组60例接受激光定位配合真空垫固定下的肺部穿刺活检,B组60例接受常规CT引导下穿刺活检,比较两组的首次穿刺成功率。结果A组穿刺成功率100％（60／60）,其中首次穿刺成功率为86．67％（52／60）,并发症发生率11．67％（7／60）;B组58例患者纳入研究,穿刺成功率为96．55％（56／58）,其中首次穿刺成功率为70．69％（41／58）,并发症发生率17．24％（10／58）。A组首次穿刺成功率高于B组（X^2=4．508,P〈0．05）。结论使用真空垫固定行CT引导下肺部穿刺活检操作简便,安全可靠,值得推广。