The DIY mini suction drain

Using readily available materials, a versatile mini suction drain system can be quickly constructed.     

Perforation of the right ventricle by a suction drain.

Suction drains can be used as alternatives to conventional underwater seal drains following cardiac surgery, and may be advantageous under some circumstances. The authors present a case where a suction drain eroded into the right ventricle causing near-fatal haemorrhage following coronary artery surgery. Caution should be exercised in taking the decision to use suction drains, the material from which they are manufactured should be chosen carefully, and close attention paid to their positioning within the mediastinum.     

A safe and effective disposable low pressure suction drain.

The physical and microbiological properties of a new disposable suction drainage system have been investigated under clinical and laboratory conditions. The system appears to have overcome the disadvantages associated with previous disposable and reusable low pressure suction drainage systems for use after surgical operation in that this system effectively prevents reflex and retrograde contamination.     

The use of the Mini-Flap wound suction drain in maxillofacial surgery.

Preliminary experience using the Mini-Flap closed suction drain after maxillofacial surgery is described. The drain fulfils many of the criteria required for drainage of small wounds about the face and neck, and is associated with a low incidence of postoperative haematoma, oozing and infection.     

The influence of the drain suction in knee arthroplasty

PROBLEM: In a prospective randomised clinical study, we investigated the impact of drain-suction on the post-operative blood loss and on both clinical and laboratory parameters after knee replacement operations. PATIENTS AND METHOD: In this study, 116 patients with unilateral implantation of knee replacements were evaluated. The patients' average age was 71.2 years. The operation was carried out mostly without tourniquet application. All patients received two wound drains, 57 with and 59 without suction. The postoperative blood loss as well as clinical and laboratory parameters were assessed. RESULTS: The average peri-operative blood loss amounted to 338 ml. The post-operative blood loss in the group without drain suction was 436 ml and 528 ml in the group with suction. No significant differences could be found concerning the hemoglobin values pre-operatively and on the first and seventh post-operative day, the drainage quantity 12, 24, 36, and 48 hours post-operatively, the wound healing and the CRP. Six patients in the group without and five patients in the group with drain-suction had to receive blood transfusions. DISCUSSION: The application of suction on the drainage system had no significant impact on the post-operative blood loss and the postoperative course. In nine out of ten cases no homologous blood was needed.     

Routine use of a suction drain in facial rhytidoplasty

The effectiveness of a suction drain in facial rhytidoplasty was evaluated in 46 women ranging in age from 41 to 78 years. The drain was placed on the left side of the face in 16 and on the right in 14, and no drain was used in 16 patients. The drain was removed in 24 hours regardless of the amount aspirated, which varied between 0 and 25 ml, with an average of 7.8 ml. Although none of these patients developed a hematoma while the drain was in place, a hematoma did occur in 1 patient on the drain side following its removal. Despite the variable quantities of fluid aspirated, there was no clinical difference in swelling noted around the face and neck area when the two sides were compared. Similarly, one could not distinguish this group of patients from those 16 who did not receive the drain. The routine use of continuous suction drains for patients undergoing rhytidoplasty is therefore probably unnecessary.     

Subgaleal suction drain leading to fatal sagittal sinus haemorrhage

The use of wound drains in surgical practice, very often falls into the realm of habit, rather than science. The utility of a prophylactic drain in surgical wounds may be questionable, but this practice is not uncommon, despite complications. We report a case of fatal haemorrhage from the superior sagittal sinus, due to a closed negative suction drain of the craniotomy wound in an infant operated upon for a growing fracture skull.     

Bacterial growth on suction drain tips. Prospective study of 489 clean orthopedic operations

The study included 489 clean orthopedic operations with implantation of major foreign materials (joint replacements and internal fixations of fractures). Specimens for culture were taken from the suction drainage system, either from the drain fluid or from the drain-tube tip or from both. Six superficial and five deep infections were seen following the operations. Only two cultures of drain fluid were positive, and neither of these became infected. Positive drain-tip cultures were seen after 56 operations, and of these, five were followed by infection. The risk of infection was increased if Staphylococcus aureus, Enterobacteriaceae, or Streptococcus faecalis was cultured from drain tips. Drain-tip cultures growing only coagulase-negative staphylococci, nonhemolytic streptococci, and corynebacteria were not correlated with increased risk of infection. There was a not significant tendency towards fewer infections if positive drain-tip cultures with virulent bacteria were treated with specific antibiotics.     

Bradycardia following negative pressure suction of subgaleal drain during craniotomy closure

Summary We report bradycardia (50 beats/min) in a patient, following application of negative pressure (50 mmHg) suction to the subgaleal drain, after an uneventful clipping of an anterior communicating artery aneurysm. This episode recurred even with application of a lesser negative pressure of 23 mmHg. It was noted that the time lag between application of suction pressure and the occurrence of bradycardia increased, from 10 sec in the former to 50 sec in the later instance. None of these episodes were associated with changes of blood pressure. Moreover, there was a temporal association between the intensity of negative pressure applied and the time of occurrence of bradycardia. This phenomenon is possibly due to intracranial hypotension causing reverse brain herniation that bears a relationship with the intensity of negative pressure applied. We recommend that negative pressure suction is avoided during skin suture and applied gradually, after the closure.     

Management of the perineal wound with constant irrigation and suction after abdominoperineal excision for cancer of the rectum. A new suction/irrigation drain

The technique of primary closure of the perineal wound combined with continuous irrigation and suction of the operative site has been used in 21 patients who underwent abdominoperineal excision for cancer of the rectum or anal canal. Primary healing occurred in 19 patients within 18 days, and all patients healed within 2 months. These results are in marked contrast to those in 38 patients treated with constant suction alone, of whom only 17 healed primarily.