surgery 6th year, tutorial (dr. abdulwahid)
DESCRIPTION
Nov. 30th, 2011TRANSCRIPT
Drains•1-Rubber•2-Silicone
• 1 -Active• 2 -Passive
1-Closed 2-Open
List of Things to Drain• ·Blood
• ·Bile
• ·Pus
• ·Urine
• ·Bowel anastomotic leaks
• ·Saliva
• ·Serum/lymph
• ·Pancreatic secretion
Closed•.Lower infection rate.
• ·Reduce risk of contaminating staff and other patients.
• ·Reduce nursing time
• ·more accurate measurement of drainage output.
• ·Protect surrounding skin from irritating discharges.
Open•Penrose for its softness and
lower tendency to be blocked.
• ·Greater patient comfort and mobility
Types of open drains
•1 .Corrugated Drain
•2 .Penrose Drain
•3 .Yeates drain
A corrugated drain
PVC
5-1-2-Penrose drain
Latex rubber, silicone
A Penrose drain
•A Penrose drain, made of soft, pliable rubber, is used to drain incisions .
Yeates drainseries of approx 2mm diameter PVC tubes attached side by side
CLOSED PASSIVE DRAINS
•1 .Pig-tail Catheters
•2 .Percutaneous Transhepatic Biliary Drains
•3 .Urinary Catheter
•4 .Intercostal Catheter
Pigtail drainrenal pelvis (i.e. as a
nephrostomy tube.(
Percutaneous Transhepatic Biliary Drains
more side-holes
Other CLOSED PASSIVE DRAINS
•Urinary Catheter
•see - Urological Catheters
Intercostal Catheter
•see - Intercostal Catheter
CLOSED SUCTION (active) DRAINS:
•1 .Bellovac®
•2 .Blake® drain
•3 .Exudrain®
•4 .Hemovac®
•5 .Jackson-Pratt®
Bellovac
Blake drain
Exudrain
Hemovac (Davol) (redivac)
Hemovac (Davol) (redivac)
Jackson-pratt drain
Jackson-pratt drain
Sump Suction Drains
sump drain
1-Mechanical Problems of drains
•.Trauma to tissues
• ·Erosion of adjacent tissues- may lead to perforation or fistula formation ,haemorrhage
• ·Herniation of viscera through the drain tract.
• ·Anastomotic leak- drains are sometimes placed near anastomoses
2-PHYSIOLOGICAL PROBLEMS
• ·Bacterial colonization and sepsis-
• ·Loss of fluid and electrolytes
Pain-
Pneumothorax pneumoperito-
• ··Restricted mobility
3-DRAIN MALFUNCTION1.Blocked Drain
•2 .Leaking Drain•3 .Loose Drain
•4 .Drain retraction•5 .Drain falling out
•6 .Broken Drain/ Tubing•7 .Inflamed Drain Exit Site
•8 .Atypical Drainage Fluids;• anastomotic leaks, or drain erosion into adjacent
structures e.g. bowel, bladder, or blood vessels.•9 .High Drainage Output
•10 .Vacuum Failure for Suction Drains