surgical drains Flashcards
what is a surgical drain?
implants that allow removal of fluid and/or gas from a wound or body cavity
What is the function of a surgical drain?
help the healing process by removing inflammatory mediators, bacteria, foreign material and necrotic tissue
relieve pressure that can impair perfusion and cause pain, thereby reducing inflammation and decreasing morbidity
enable monitoring of potential complications; for example, measurement and sampling of fluid / gas within the cavity that the drain has been placed
Elimination of deadspace
Removal of existing fluid or gas
Prevention of accumulation of fluid or gas within the wound
What are the classifications of drains?
open or closed
Active or passive
Describe passive drains
Rely on gravity, body movement, pressure differentials, or overflow to move fluid or gas
e.g., Penrose drain
How do Penrose drains work?
They work by capillary action, gravity, overflow, or fluctuations of pressure gradients caused by body movement
Penrose drains are tubular, fluid moves out of the body by capillary action along the external surface of the drain, not through the lumen
Why should you not have a drain exit in 2 places?
Increases the risk for infection and decreases drain efficiency
Why should a passive drain be covered by a bandage?
Prevent infection
Prevent skin irritation due to fluid
Prevent patient biting drain
Provides a way to roughly estimate fluid production
What are active drains?
Active drains are closed systems that collect fluid into a reservoir
What are the benefits of an active drain?
prevents saturation of bandage material
decreases the risk for ascending infection
can limit exposure of hospital staff or other patients to contaminated fluid
optimises drain function to reduce amount of time drain is in place
How do active drains work?
Apply an artificial pressure gradient to pull fluid or gas from a cavity
What are common types of active drains?
Jackson-Pratt drain (grenade drain)
Thoracostomy (chest) drain
What are the advantages of active drains over passive drains?
decreased risk for ascending infection
ability to be used in areas that are difficult to bandage
decreased risk for skin excoriation
accurate assessment of volume of fluid being produced
easy collection of fluid for cytology or chemical analysis with less possibility of environmental contamination of the fluid
ability to collapse dead space
