Surgical Drains Indications, Types Principals of Use：外科引流的适应症，使用类型与原则.pptVIP

Surgical Drains:Indications, Types, Principals of Use Learning Objectives Goals / Indications for Use Why use a drain ? Types What are the major types of drains and how do they work ? Principals of Use Which drain to use ? What are the complications ? Goals Decrease Infection Rate Decrease Healing Time Indications To help eliminate dead space To evacuate existing accumulation of fluid or gas To prevent the potential accumulation of fluid or gas Drain Types Flat Dependent on gravity and capillary action Drainage related to surface area Penrose - latex Drain Types Flat drains - Penrose Advantages Allow drainage Help obliterate dead space Soft / malleable – less painful Disadvantages Very irritating Allow bacterial ingress Cannot be connected to suction Gravity dependent Drain Types Tube Single lumen +/- side holes Silicone, polyvinyl chloride, red rubber Drain Types Tube drains Advantages Drain from both within and outside of lumen Can be connected to suction Can be used with closed collection system Disadvantage Discomfort due to stiffness Drain Types Double lumen Sump drains – open/open suction Drainage of fluid via large lumen Sump lumen – smaller and allows ingress of air Drain Types Double lumen Advantages More efficient than single lumen Maintain patency longer than single lumen Disadvantages Risk of contamination of wound as environmental air drawn in – reduced with filter Drain Types Passive Active Continuous suction Intermittent suction Passive Drains Passive Drain by means of pressure differentials, overflow, and gravity Provides a stent that keeps a draining tract / cloaca open Allow egress via a path of least resistance Flat or with a lumen Open or Closed – Closed preferred Passive Drains Passive closed Advantages Allow evaluation of volume and nature of fluid Prevent bacterial ascension Eliminate dead space Help appose skin to wound bed – quicker wound healing Disadvantages Gravity dependent – affects location of drain Drain easily clogged