ASPIRATION DRAINAGE

From Big Medical Encyclopedia

ASPIRATION DRAINAGE - active long suction of liquid and gas from perigastriums, wounds, especially postoperative, by means of various aspirators. These devices create adjustable depression that causes uniform and continuous evacuation of contents of a cavity in the collector which is in a loop system between an aspirator and the patient. Existence of a collector allows to judge quantity, quality of separated and to make microscopic, biochemical and other examinations of the last.

Fig. 1. A water-suction pump with system from two cans: 1 — the crane of a water supply system; 2 — a water-suction pump; 3 — a needle - the pressure governor; 4 — a buffer vessel; 5 — the collector for a drain of pus; 6 — a pleural cavity from which purulent liquid is aspirated. Shooters specified the direction of current of the sucked-away liquid and air.
Fig. 2. Aspiration drainage by the device of negative pressure (Subbotin's device — Pertesa).

And convenient the water-suction pump (fig. 1) is simple. Also electrovacuum devices of the individual and centralized appointment with inclusion in system of a large bottle buffer are used to pressure decrease to the necessary level. For removal of liquid the drainage tube (rubber, polyethylene, silicone) is entered into the most lower part of a cavity or a wound, for removal of gas — into its top-most department. On a drainage do several small side openings for the prevention of suction of a tube to a wall of a cavity. The drainage is removed or through the main wound, or is more often out of it and is fixed by a seam to skin. All system of long drainage shall not limit the movements of the patient in a bed. It is widely used And. of the serous cavities, hollow bodies and cavities formed as a result of an injury, pathological process (a hematoma, a cyst, abscess, flowed) or operations (wound). Most often And. is applied in the early postoperative period after lung operations and bodies of a mediastinum for the prevention of a collapse of a lung and shift of a mediastinum by pleural exudate or air, and also to treatment of spontaneous pheumothorax and an empyema of a pleura. And. of a stump of a stomach after its resection is applied as a method of prevention of insolvency of seams of a stump of a duodenum and a gastroenteroanastomosis. And. of purulent zatek of an abdominal cavity, interintestinal and subphrenic abscesses, cysts and abscesses of a liver, a spleen, a pancreas — one of the main methods of their treatment. And. to it is absolutely shown for a decompression of a stomach and a small bowel for the purpose of prevention and treatment of paresis of these bodies at peritonitis. At post-resection disorders of evacuation apply aspiration of contents of a stump of a stomach the device of negative pressure of Subbotin — Pertesa (fig. 2). Vacuum aspiration provides bystreyshy healing of postoperative wounds, napr, after a radical mastectomy, to a bryushnopromezhnostny extirpation of a rectum. At the last operation A. is used only on condition of a perfect hemostasis and sewing up of a wound of a crotch tightly.

See also Byulau drainage , Intubation of intestines .

Fig. 3. The sucking-away V. I. Rusakov's device: 1 — a vessel with water; 2 — a vessel with antiseptic liquid; 3 and 9 — Mohr pinchcock clamps; 4 — a tube for injection of antiseptic liquid in a bladder; 5 — a tube for removal of liquid from a bladder; 6 — a dropper; 7 — a vessel for collecting of liquid from a bladder; 8 — a vessel for collecting of water. Shooters specify the direction of current of liquid.

Aspiration drainage in urology it is applied to active suction purulent separated from pyelocaliceal system of a kidney, a bladder, retroperitoneal space, a small pelvis for the purpose of creating favorable conditions for healing of wounds.

Indications: bladder operations with imposing of suprapubic fistula; injury of a bladder and urethra; purulent and uric accumulations in cellulose of retroperitoneal space or a basin; after plastic surgeries on a lokhanochno-ureteric segment, an ureter and an urethra; after an adenomectomy of a prostate.

In some cases along with And. continuous irrigation of a wound antiseptic solutions is reasonable to carry out. For this purpose in the cavity which is subject to drainage leave two thin rubber tubes with side openings on the proximal end. At drainage of a kidney it is better to apply polyethylene tubes. The end of one tube is attached to an aspirator, the second — to the sterilized vessel with antiseptic solution. The sucking-away device offered by V. I. Rusakov (fig. 3) is most convenient. The device does not demand difficult leaving, continuous observation, provides continuous and full aspiration separated and the dosed administration of antiseptic solution, allows to dose extent of the created depression easily. System A. does not limit movements of the patient in a bed.

Usually And. apply during 7 — 10 days.

There are no contraindications to use of this method. See also Aspirators .


Bibliography: Akhundov A. G. To a question of active aspiration from a pleural cavity after intrathoracic operations, Azerbaydzhansk. medical zhurn., No. 11, page 60, 1970; Wangqiang E. N. Is also lean - to about in R. A. Treatment of burns and cicatricial esophageal stenoses, M., 1971; Gayduk of the Item X. To a technique of drainage of an abdominal cavity, in book: Vopr. patol, digestive organs, under the editorship of A. P. Ury cinchona, page 151, Kiev, 1963, bibliogr.; Inoyatov I. M. and Alexandrov V. V. Treatment of a perineal wound after amputation of a rectum vacuum aspiration, Surgery, No. 1, page 74, 1971; Podgorbunsky M. A. T. I ishrayer. The getting damages and perforation of a gullet, page 206, Kemerovo, 1970; Pytel A. Ya. and Goligorsky S. D. Elected heads of nephrology and urology, p. 3, L., 1973; V. I Hares. Strictures of an urethra, M., 1962; North V. S., Shiffman N. D. and Gromova L. S. Use of the aspiration device of system H. M. Titarenko in clinic of pulmonary surgery, Grudn. hir., No. 2, page 117, 1963; V. I Pods. Purulent diseases of lungs and pleura, page 51, L., 1967; At of l about in F. G., P at of l e-, e in and V. P. and I to about in l e in and A. M. Complications at intrathoracic operations, page 216, L., 1966.

O. A. Narycheva; M. V. Pinevich (Ur.).

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