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使用新型导管固定装置防止意外引流管脱落。

Preventing inadvertent drain removal using a novel catheter securement device.

机构信息

Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.

Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.

出版信息

Sci Rep. 2023 Sep 26;13(1):16130. doi: 10.1038/s41598-023-37850-2.

Abstract

Percutaneous drains have provided a minimally invasive way to treat a wide range of disorders from abscess drainage to enteral feeding solutions to treating hydronephrosis. These drains suffer from a high rate of dislodgement of up to 30% resulting in emergency room visits, repeat hospitalizations, and catheter repositioning/replacement procedures, which incur significant morbidity and mortality. Using ex vivo and in vivo models, a force body diagram was utilized to determine the forces experienced by a drainage catheter during dislodgement events, and the individual components which contribute to drainage catheter securement were empirically collected. Prototypes of a skin level catheter securement and valved quick release system were then developed. The system was inspired by capstans used in boating for increasing friction of a line around a central spool and quick release mechanisms used in electronics such as the Apple MagSafe computer charger. The device was tested in a porcine suprapubic model, which demonstrated the effectiveness of the device to prevent drain dislodgement. The prototype demonstrated that the miniaturized versions of technologies used in boating and electronics industries were able to meet the needs of preventing dislodgement of patient drainage catheters.

摘要

经皮引流为治疗各种疾病提供了一种微创方法,从脓肿引流到肠内喂养解决方案,再到治疗肾积水。这些引流管存在高达 30%的高脱落率,导致急诊就诊、再次住院和导管重新定位/更换手术,带来了显著的发病率和死亡率。通过离体和体内模型,利用力体图确定引流管在脱落事件中所经历的力,并通过经验收集有助于引流管固定的各个组件。然后开发了一种皮肤水平导管固定和带阀快速释放系统的原型。该系统的灵感来自于船只上用于增加中心卷轴周围线的摩擦力的绞盘,以及电子产品(如苹果 MagSafe 电脑充电器)中使用的快速释放机制。该设备在猪的耻骨上模型中进行了测试,该模型证明了该设备能够有效防止引流管脱落。该原型表明,船只和电子行业使用的小型化技术版本能够满足防止患者引流管脱落的需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8777/10522644/e3d9bdeab5fc/41598_2023_37850_Fig1_HTML.jpg

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