Flanagan Sean, Logan David, Joseph Mark G
Department of Surgery Concord General Repatriation Hospital, Concord, Sydney New South Wales, Australia.
ANZ J Surg. 2002 Nov;72(11):806-7. doi: 10.1046/j.1445-2197.2002.02555.x.
The debate over the use of drains in abdominal surgery is controversial. Selective drainage using a closed system is the method employed by most surgeons. There are, however, specific circumstances where different forms of drainage are required.
One hundred and sixty-seven patients undergoing a mix of complex upper gastrointestinal surgery and colorectal surgery received an Axiom sump drain at the time of surgery. All side air vents were spigoted and the main lumina connected to a urine bag, with the option to convert to irrigation/suction as required.
Two patients required conversion to irrigation/suction, because of ongoing egress of fluid. In both cases drainage ceased without surgical intervention. The remaining cases resolved with no complications related to the drain.
The technique described allows the use of a large bore, soft, gravity-driven drain in cases where wound drainage is necessary. The closure of the ventilation ports maintains the advantage of a closed drainage system, yet allows for the conversion to a true sump system as required. This obviates the need for further drainage procedures.
腹部手术中引流管使用的争论颇具争议。大多数外科医生采用的方法是使用封闭系统进行选择性引流。然而,在某些特定情况下需要不同形式的引流。
167例接受复杂上消化道手术和结直肠手术的患者在手术时接受了Axiom集液引流管。所有侧孔均被堵塞,主腔连接到尿袋,并可根据需要转换为冲洗/吸引。
2例患者因持续有液体流出而需要转换为冲洗/吸引。在这两种情况下,引流在未进行手术干预的情况下停止。其余病例均无与引流管相关的并发症而痊愈。
所描述的技术允许在需要伤口引流的情况下使用大口径、柔软、重力驱动的引流管。通气口的封闭保持了封闭引流系统的优势,但允许根据需要转换为真正的集液系统。这避免了进一步引流操作的必要性。