surgical drain its types and uses

1. Surgical Drains
BY DR LAIQ MUHAMMAD
TMO SBW STH

2. INTRODUCTION
THESE ARE APPLIANCES
THAT ACT AS DELIBERATE
CHANNELS WHICH IS USED
TO DRAIN ESTABLISHED
OR POTENTIAL COLLECTION
OF BLOOD,PUS OR AIR.

3. IDEAL DRAIN
AN IDEAL DRAIN SHOULD BE….
 FIRM,NOT TOO RIGID.
 IT SHOULD NOT BE TOO SOFT AS IT MAY TWIST OR KINK OR BECOME BLOCKED.
 SMOOTH
 IT SHOULD BE RESISTANT TO DECOMPOSITION OR DISINTEGRATION
 WIDE AND PATENT ENOUGHTO PREVENT EASY BLOCKAGE.
 IT SHOULD BE NON ELECTROLYTIC NON CARCINOGENIC AND NON THROMBOGENIC WHEN USED IN
VASCULAR SURGERY.

4. CLASSIFICATION
OF DRAINS
SURGICAL DRAINS CAN BE
A. OPEN OR CLOSED
B. ACTIVE OR PASSIVE

5. PASSIVE VS ACTIVE DRAINS
PASSIVE DRAINS
THAT TYPE OF DRAINS THAT SIMPLY ACT BY
MEANS OF THE CAPILLARY ACTION OR GRAVITY.
 EXAMPLES
 CORRUGATED RUBBER DRAIN
 PENROSE DRAIN(A VERY SOFT RUBBER TUBE WITH
GUAZE WICK INSIDE).
 SUMP DRAIN(A multiple lumen tube for continuous
drainage,irrigation,and aspiration)
 THESE DRAINS ARE USED WHEN DRAINAGE
FLUID IS TOO VISCOUS.
ACTIVE DRAINS
 THESE ARE TUBE DRAINS THAT ARE AIDED BY
ACTIVE SUCTION.
 EXAMPLES.
 REDIVAC DRAINS
 HAEMOVAC
 SURGIVAC
 JACKSON-PRATT DRAIN

6. PASSIVE VS ACTIVE DRAINS
PASSIVE DRAINS ACTIVE DRAINS

7. INDICATION OF
DRAINS
THERE ARE DIFFERENT
INDICATIONS.IT INCLUDE
1. THERAPEUTIC
2. DIAGNOSTIC
3. PROPHYLACTIC
4. MONITORING
5. PALLIATIVE

8. THERAPEUTIC
 TENSION PNEUMOTHORAX
 PLEURAL FLUID
 ABSCESS CAVITY
 SEROMA
 ACUTE URINARY RETENTION
 ACUTE SUPPORATIVE ARTHRITIS
 INFECTED CYST

9. DIAGNOSTIC
 T-TUBE CHOLANGIOGRAM FOR RETAINED GALL
STONES IN COMMON BILE DUCT
 BILIARY FISTULA.

10. PROPHYLACTIC
 POST THYROIDECTOMY
 THORACOTOMY
 SPLENECTOMY
 PANCREATECTOMY
 ESOPHAGEAL RESECTION
 CARDIOTHORACIC PROCEDURES

11. MONITORING AND PALLIATIVE
FOR MONITORING IT IS USE FOR.
GASTROINTESTINAL BLEEDING.
URETHRAL CATHERIZATION.
FOR PALLIATIVE.
ADVANCED CA ESOPHAGUS.
HYDROCEPHALUS.

12. CARE OF SURGICAL DRAIN
IT INCLUDES
 INTRA OPERATIVE CARE
 SECURING A SURGICAL DRAIN
 POST OPERATIVE CARE

13. A. INTRA OPERATIVE CARE
 PLACED SUCH THAT THEY TAKE THE SAFEST ,SHORTEST ROUTE
POSSIBLE.
 SHOULD REACH THE DEEPEST,MOST DEPENDENT PART OF THE
CAVITY OR WOUND.
 TUBES SHOULD REMAIN FREE OF KINKS,DEBRIS AND CLOTS.
 SHOULD BE SECURED WELL TO AVOID FALLING OFF OR ITS
MIGRATION INTO THE CAVITY OR EROSION OF SURROUNDING
TISSUE.
 DRAIN SHOULD BE LOWER THEN THE INCISION AT ALL TIMES.

14. B. SECURING A SURGICAL DRAIN
DRAINS HAVE BEEN SECURED USING VARIOUS TECHNIQUES AND
MATERIALS.
 ROMAN GARTER TECHNIQUE WHICH USES SILK TO SECURE THE DRAIN.
 USES OF NYLON SUTURES.
 SAFETY PIN.
 DRAIN CLIP.
 ADHESIVE.

15. C. POST OPERATIVE CARE
THE POST OPERATIVE CARE DEPENDS ON THE TYPE,PURPOSE AND LOCATION OF THE DRAIN.
 SKIN AROUND THE WOUND MUST BE KEPT CLEAN,AND DRY TO PREVENT INFECTION AND SKIN
IRRITATION.
 METICULOUS SKIN CARE AND ASEPTIC TECHNIQUES MUST BE OBSERED DURING APPLICATION
AND CHANGE OF DRESSING OVER DRAIN.
 GAUZE DRESSING ARE USED AROUND AND OVER DRAINAGE TUBES.
 TO PROTECT THE TUBE
 ABSORB SOME AMOUNT OF DRAINAGE.
 ASSIST WITH THE STABILIZATION OF THE TUBES.
 PROTECT FROM EXTERNAL CONTAMINATION.
 AN ACCURATE MEASUREMENT AND RECORD KEEPING OF DRAINAGE OUTPUT.
 DRAIN CONTAINER SHOULD BE EMPTIED AT LEAST ONCE A DAY.

16. WHEN TO DISCONTINUOUS A SURGICAL
DRAIN.
 ONCE THE DRAINAGE HAS STOPED.
 ITS OUT PUT HAS BECOME <25-50 ML/DAY.
 THE DRAIN HAS STOPPED SERVING THE DESIRED
FUNCTION.

17. COMPLICATIONS.
 IMMEDIATE.
 PAIN
 IRRITATION
 BLEEDING
 PERFORATTION OR INJURY TO ADJACENT STRUCTURES.
 EARLY.
 OCCLUSION
 LEAKING AROUND DRAIN
 DISPLACEMENT
 INFECTION
 LOSS OF FLUID,ELECTROLYTES AND PROTEIN

18. COMPLICATIONS….
 LATE.
 PRESSURE/SUCTION NECROSIS OF BOWL OR VESSEL.
 FISTULA.
 SCAR.
 HERNIA.
 COMPLICATIONS DURING REMOVAL.
 PAIN
 INFECTION(CELLULITIS/ABSCESS)
 INJURY TO ADJACENT STRUCTURES.
 RETAINED OR FRAGMENTATION OF TUBE.

19. CONCLUSIONS.
THE USE OF DRAINS IN SURGICAL PRACTICE HAS BEEN CONTENTIOUS OVER
THE YEARS.
THE ESSENTIAL QUESTIONS A SURGEON NEEDS TO ANSWER WHEN DECIDING
ON THE VALUE OF SURGICAL DRAINS ARE..
 WHAT PURPOSE WOULD A DRAIN SERVE IF PLACED?
 WHAT TYPE OF DRAIN SHOULD BE USED?
 HOW LONG SHOULD THE DRAIN BE LEFT IN PLACE?
ONCE THESE QUESTIONS ARE CAREFULLY AND ADEQUATELY ANSWERED EACH
TIME A DRAIN IS USED, THE EFFECTIVENESS AND ADVANTAGE CAN BE
MAXIMIZED WITH MINIMAL PROBLEMS.

20. THANK YOU