Surgery 6th year, Tutorial (Dr. AbdulWahid)

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Nov. 30th, 2011

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Surgery 6th year, Tutorial (Dr. AbdulWahid)

  1. 1. Drains <ul><li>1-Rubber </li></ul><ul><li>2-Silicone </li></ul><ul><li>1- Active </li></ul><ul><li>2- Passive </li></ul>1-Closed 2-Open
  2. 2. List of Things to Drain <ul><li>· Blood </li></ul><ul><li>· Bile </li></ul><ul><li>· Pus </li></ul><ul><li>· Urine </li></ul><ul><li>· Bowel anastomotic leaks </li></ul><ul><li>· Saliva </li></ul><ul><li>· Serum/lymph </li></ul><ul><li>· Pancreatic secretion </li></ul>
  3. 3. Closed <ul><li>.Lower infection rate. </li></ul><ul><li>· Reduce risk of contaminating staff and other patients. </li></ul><ul><li>· Reduce nursing time </li></ul><ul><li>· more accurate measurement of drainage output. </li></ul><ul><li>· Protect surrounding skin from irritating discharges. </li></ul>
  4. 4. Open <ul><li>Penrose for its softness and lower tendency to be blocked. </li></ul><ul><li>· Greater patient comfort and mobility </li></ul>
  5. 5. Types of open drains <ul><li>1. Corrugated Drain </li></ul><ul><li>2. Penrose Drain </li></ul><ul><li>3. Yeates drain </li></ul>
  6. 6. A corrugated drain PVC
  7. 7. 5-1-2-Penrose drain Latex rubber, silicone
  8. 8. A Penrose drain <ul><li>A Penrose drain, made of soft, pliable rubber, is used to drain incisions . </li></ul>
  9. 9. Yeates drain series of approx 2mm diameter PVC tubes attached side by side
  10. 10. CLOSED PASSIVE DRAINS <ul><li>1. Pig-tail Catheters </li></ul><ul><li>2. Percutaneous Transhepatic Biliary Drains </li></ul><ul><li>3. Urinary Catheter </li></ul><ul><li>4. Intercostal Catheter </li></ul>
  11. 11. Pigtail drain renal pelvis (i.e. as a nephrostomy tube).
  12. 12. Percutaneous Transhepatic Biliary Drains more side - holes
  13. 13. Other CLOSED PASSIVE DRAINS <ul><li>Urinary Catheter </li></ul><ul><li>see - Urological Catheters </li></ul><ul><li>Intercostal Catheter </li></ul><ul><li>see - Intercostal Catheter </li></ul>
  14. 14. CLOSED SUCTION (active) DRAINS : <ul><li>1. Bellovac® </li></ul><ul><li>2. Blake® drain </li></ul><ul><li>3. Exudrain® </li></ul><ul><li>4. Hemovac® </li></ul><ul><li>5. Jackson-Pratt® </li></ul>
  15. 15. Bellovac
  16. 17. Blake drain
  17. 18. Exudrain
  18. 19. Hemovac (Davol) (redivac)
  19. 20. Hemovac (Davol) (redivac)
  20. 21. Jackson-pratt drain
  21. 22. Jackson-pratt drain
  22. 23. Sump Suction Drains
  23. 24. sump drain
  24. 25. 1-Mechanical Problems of drains <ul><li>.Trauma to tissues </li></ul><ul><li>· Erosion of adjacent tissues- may lead to perforation or fistula formation ,haemorrhage </li></ul><ul><li>· Herniation of viscera through the drain tract. </li></ul><ul><li>· Anastomotic leak- drains are sometimes placed near anastomoses </li></ul>
  25. 26. 2-PHYSIOLOGICAL PROBLEMS <ul><li>· Bacterial colonization and sepsis- </li></ul><ul><li>· Loss of fluid and electrolytes </li></ul><ul><li>Pain- </li></ul><ul><li>Pneumothorax pneumoperito- </li></ul><ul><li>·· Restricted mobility </li></ul>
  26. 27. 3-DRAIN MALFUNCTION <ul><li>1.Blocked Drain </li></ul><ul><li>2. Leaking Drain </li></ul><ul><li>3. Loose Drain </li></ul><ul><li>4. Drain retraction </li></ul><ul><li>5. Drain falling out </li></ul><ul><li>6. Broken Drain/ Tubing </li></ul><ul><li>7. Inflamed Drain Exit Site </li></ul><ul><li>8. Atypical Drainage Fluids; </li></ul><ul><li>anastomotic leaks, or drain erosion into adjacent structures e.g. bowel, bladder, or blood vessels. </li></ul><ul><li>9. High Drainage Output </li></ul><ul><li>10. Vacuum Failure for Suction Drains </li></ul>

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