RU227709U1 - Aspiration drainage - Google Patents

Abstract

The utility model relates to medical equipment, namely to devices intended for drainage of wounds and cavities after surgery. The technical result of the utility model is the ability to use the external tube as a passive outflow drainage, and, if necessary, by installing the internal tube as an aspiration one, the ability to flush the internal tubes and replace them an unlimited number of times according to indications; ensuring the evacuation of not only extravasate, but also small and coarse substances (feces, thick pus with fibrin, blood clots).

Description

The utility model relates to medical equipment, namely to devices intended for draining wounds and cavities after surgery.

The problem of cavity infection after surgical interventions is very relevant, in particular after surgical interventions on the organs of the chest, abdominal cavity, small pelvis and retroperitoneal space. As a rule, drainage is performed by passive drains [V.D. Fedorov. Clinical operative proctology. 1994].

The disadvantage of this drainage method is that it does not always provide adequate outflow and timely evacuation of pathological contents.

A drainage device is known (A.S. 1832035) containing an external perforated tube and an internal coaxially located tube, forming longitudinal channels with inlet and outlet sockets.

The disadvantages of the known drainage device are the unreliable fastening of the internal tubes to the external tube, which can cause interruptions in the operation of the device and can affect the quality of treatment of the patient.

A surgical drainage is known (RU patent No. 1793935), which contains an external perforated tube and an internal tube with lateral openings movably installed inside it. The external tube has a screw-through channel, and the internal tube has traps for thrombi with openings at the bases of the traps, while the perforated openings of the external and internal tubes are smaller than the diameter of the openings of the internal tube.

The disadvantages of the known surgical drainage are the short life of the outer tube, due to the presence of a screw channel in its wall, which reduces the cross-sectional area of the tubes, and the inability to evacuate liquid media and dispersed substances from the wound and cavities.

A drainage device called "Aspiration drainage "pipe in pipe"" is known (Patent RU No. 100726, IPC A61M 27/00 - 27.12.2010, Bulletin No. 36), comprising an outer pipe and an inner pipe installed in it, made of medical polyvinyl chloride plastic compound of the PM-1/42 brand, characterized in that the distal end of the outer pipe of a spherical shape is plugged, a retainer is made on the proximal end of the inner pipe for fixing the inner pipe in the outer one, the length of the outer pipe is 350 mm, the diameter is 9 mm, the length of the inner pipe is 400 mm, the diameter is 3 mm, the wall thickness is 1.7 mm, four holes of a 3 mm diameter of an ovoid shape are made on the outer pipe, 10 mm apart from each other, located in a checkerboard pattern over 1/2 of the circumference, the second half is left whole, the distal end of the inner pipe is made at an angle of 45 °, At a distance of 5 mm from the distal end, a hole with a diameter of 1.5 mm is made, while the connection of the tubes is detachable, which allows for disassembly and cleaning.

The disadvantages of this device are the following:

the presence of only one hole at the proximal end of the outer tube can disrupt the operation of the drainage in the event that the drainage is sucked onto the patient's skin or tissues through this hole, after which, due to the lack of air circulation, the pressure in the tube increases, aspiration stops and the risk of tissue and organ suction in the drained cavity increases.

the presence of only four holes at the distal end of the outer tube increases the risk of their blockage, with subsequent cessation of aspiration

the presence of holes in only one semicircle at the distal end can lead to incomplete drainage of the cavity.

The 1.5 mm diameter hole at the distal end of the inner tube may increase the risk of it becoming clogged with coarse discharge, which will lead to the cessation of aspiration.

This product is taken as a prototype.

The objective of the claimed utility model is to simplify the device and increase durability.

The technical result of the utility model is the ability to use the external tube as a passive outflow drainage and, if necessary, by installing the internal tube as an aspiration tube, the ability to flush the internal tubes and replace them an unlimited number of times according to indications; ensuring the evacuation of not only extravasate, but also small and coarse substances (feces, thick pus with fibrin, blood clots).

The technical result is achieved in that in the aspiration drainage comprising an outer tube and an inner tube installed therein, made of medical polyvinyl chloride plastic compound of the PM-1/42 brand, the distal end of the outer tube of a spherical shape is plugged, at the proximal end of the inner tube there is a connecting tube for connection to the external aspiration system and a retainer for fixing the inner tube with the outer one, the length of the outer tube is 350 mm, the outer diameter is 9 mm, the wall thickness is 1.225 mm, the length of the inner tube is 400 mm, the outer diameter is 3 mm, the wall thickness is 0.7 mm, at the proximal end of the outer tube there are holes with a diameter of 3 mm made opposite each other, at the distal end of the outer tube there are 8 holes with a diameter of 3 mm, 10 mm apart from each other, arranged in a staggered manner, the distal end of the inner tube is made at an angle of 45°, at a distance of 5 mm from the distal end there is a hole with a diameter of 2.0 mm. The tube connection is detachable, which allows disassembly, cleaning and replacement of the inner tube. If necessary, the outer tube can be used without the inner tube, thereby using it as a passive outflow drainage.

The proposed utility model allows increasing the durability of the drainage due to the fact that there are no windows or slits in the wall of the outer pipe that would reduce the cross-sectional area of the pipe and negatively affect the durability. The diameter of the opening of the ovoid-shaped outer pipe, equal to 3 mm, is optimal, since an increase in diameter of more than 3 mm can lead to "suction" of tissues and further development of their necrosis is possible. The diameter of the openings of the ovoid-shaped outer pipe should correspond to the surface tension of connective tissues and atmospheric pressure in the vacuum system, which should not exceed 0.3 atmospheres. The maximum length of the outer pipe is 350 mm. This size is determined in accordance with the size of the wound and the expected size of the pipe outside the wound.

The outer diameter of the outer pipe is 9 mm. This parameter is the most optimal in places where the outer pipe exits the wound in order to prevent skin defects. The length of the inner pipe is 400 mm, it should not exceed the length of the outer pipe by more than 50 mm. The outer diameter of the inner pipe is 3 mm. Provides for the removal of liquid media from the wound and cavities. Making eight holes in the wall of the outer pipe at the distal end with a diameter of 3 mm, 10 mm apart from each other, staggered on both semicircles, which allows for the evacuation of small and coarse substances, the 10 mm step is associated with the control of the evacuation of substances. A hole with a diameter of 3 mm, made at the proximal end of the outer pipe, serves to suck air into the drainage pipe and form an air flow. Additionally, a similar hole is made opposite the previous hole, which prevents the possibility of suction to the patient's tissues and skin, thereby maintaining the safe operability of the drainage.

A 2.0 mm diameter hole made at the distal end of the inner tube ensures the creation of a turbulent air flow for more effective removal of contents from the lumen of the outer tube. The thickness of the tube walls, equal to 1.225 mm and 0.7 mm, is made to prevent bending of the tubes in the wound. The connecting tube at the proximal end of the inner tube provides convenience for connection to the external aspiration system. The tubes are made of medical plastic compound grade PM-1/42, which facilitates the installation of drainage in the wound.

The essence of the utility model is explained by drawings, which depict:

Fig. 1 – Drainage assembly;

in Fig.2 – Inner tube;

in Fig.3 – Outer tube.

The following positions are indicated by numbers on the figures:

1 - connecting tube for connection to external aspiration system; 2 - retainer; 3 - internal drainage tube; 4a and 4b - openings on the external tube for sucking in air; 5 - external drainage tube; 6 - openings on the external tube for sucking in liquid medium from cavities in the amount of 8 pieces; 7 - opening on the internal tube for creating a turbulent air flow to remove contents from the lumen of the external tube.

Implementation of a utility model

The aspiration drainage comprises an outer pipe and an inner pipe installed therein, made of medical polyvinyl chloride plastic compound of the PM-1/42 brand, according to the utility model the distal end of the outer pipe of a spherical shape is plugged, a retainer is made at the proximal end of the inner pipe for fixing the inner pipe in the outer one, the length of the outer pipe is 350 mm, the outer diameter is 9 mm, the wall thickness is 1.225 mm, the length of the inner pipe is 400 mm, the outer diameter is 3 mm, the wall thickness is 0.7 mm, on the outer pipe there are 8 holes of an ovoid shape with a diameter of 3 mm, a step of 10 mm from one another, located in a checkerboard pattern on both semicircles, and at the proximal end there are 2 holes opposite each other with a diameter of 3 mm, the distal end of the inner pipe is made at an angle of 45°, at a distance of 5 mm from the distal end there is a hole with a diameter of 2.0 mm. The tube connection is detachable, which allows for disassembly and cleaning.

Drainage of the patient's wound using manual aspiration drainage is carried out as follows.

The part of the outer tube with 8 holes is placed in the wound and the wound is sutured. The inner tube is moved from the proximal end and fixed with a clamp. After removing the inner tube from the clamp, it is taken out of the distal end of the tube if it is necessary to replace the latter or prolong the drainage in passive mode.

When draining a wound using a suction drainage system, the aspiration system is connected to the connecting tube for connection and the cavity is drained.

The proposed method has been used on more than 1000 patients, and in none of the cases were purulent complications from the cavities observed.

Example 1

Patient A., 67 years old, after low anterior rectal resection with total mesorectumectomy, a failure of the sutures of the colorectal anastomosis was diagnosed on the 7th day. Considering the retroperitoneal location of the anastomosis and aspiration drainage of the presacral space using the original technique, it was possible to prevent the development of an abscess and peritonitis, and the fistula healed conservatively due to prolonged drainage and without the formation of an intestinal stoma.

Thus, the claimed drainage reduces the frequency of inflammatory processes and associated complications.

This drainage is of particular practical importance in patients with purulent complications in the pelvic area and intestinal anastomosis failure, including after intra-abdominal and abdomino-anal resections of the rectum. Drainage with the help of drainage allows avoiding repeated operations and resolving complications conservatively. This is especially important for elderly patients and patients with severe concomitant pathology, for whom anesthesia and repeated surgical intervention to resolve inflammatory complications may be fatal due to the addition of complications of the respiratory and cardiac systems.

Claims (1)

Aspiration drainage comprising an outer tube and an inner tube installed therein, made of medical polyvinyl chloride plastic compound of the PM-1/42 brand, characterized in that the distal end of the outer tube of a spherical shape is plugged, a connecting tube for connection to an external aspiration system and a retainer for fixing the inner tube to the outer one are made at the proximal end of the inner tube, the length of the outer tube is 350 mm, the outer diameter is 9 mm, the wall thickness is 1.225 mm, the length of the inner tube is 400 mm, the outer diameter is 3 mm, the wall thickness is 0.7 mm, holes with a diameter of 3 mm are made opposite each other at the proximal end of the outer tube, 8 holes with a diameter of 3 mm are made in a checkerboard pattern at a pitch of 10 mm from one another, the distal end of the inner tube is made at an angle of 45 °, at a distance of 5 mm from the distal end there is a hole with a diameter of 2.0 mm, wherein the connection of the tubes is detachable, which allows for disassembly and cleaning.