RU2454948C1 - Method of fascine drainage of delimited cavities - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to field of medicine. Drainage of cavities with bundle of perforated or intact tubes. In formation of drainage length of tubes in cavity is reduced step-by-step. Tubes are removed successively, starting with the longest one and finishing with the shortest one. Method ensures successive closure of cavity walls.

EFFECT: step-by-step shortening and narrowing of drainage canal reduces terms of adhesion and reduces possibility of development of complications.

Description

The invention relates to medicine, namely to surgery.

There is a method of draining delimited spaces in soft tissues or in the abdominal cavity (Douglas, subhepatic, subphrenic, stuffing bags) by single, double or paired, double or multi-lumen tubes [1, 2, 3].

The disadvantages of the method include incomplete drainage of the contents of the cavities and uneven closure of the walls of the drainage channel after removal of the drainage, which contributes to an increase in the healing time of the cavity and the occurrence of secondary purulent-inflammatory complications.

Incomplete drainage of cavities occurs due to obstruction of the lumen of the tubes with fibrin, pus, blood clots, necrotic tissues. Stagnation of the contents activates the inflammatory process and increased exudation, which leads to the formation of residual cavities along the drainage channel. After removal of the drainage, the closure and fusion of the walls of the drainage channel occurs unevenly, creating conditions for purulent-inflammatory complications.

For the prototype, we took the method of facial drainage of cavities, which consists in taking a bundle of solid or perforated tubes of the same length to drain a delimited cavity or different lengths when draining several spaces of the abdominal cavity. In this case, the drainage function is improved, compared with the analogue, due to an increase in the number of tubes and the presence of spaces between the tubes [4].

The disadvantages of the prototype are the long term of overgrowth of the drainage channel from the tube bundle and the continuing possibility of the occurrence of residual cavities, as a result of uneven closure (heal) of the cavity after removal of the drainage, and the development of secondary purulent-inflammatory complications.

The aim of the present invention is to reduce the healing time of drained cavities and reduce secondary purulent-inflammatory complications.

This goal is achieved by the fact that during the formation of fashional drainage, the tubes in the cavity are shortened stepwise, and removed sequentially, starting with the longest and ending with the shortest. At the same time, the walls of the cavity are closed sequentially - the drainage canal is shortened along with its narrowing along the entire length, which shortens the healing time of the latter, and reduces the likelihood of developing residual cavities and secondary purulent-inflammatory complications (Figure 1, a, b, c).

The method is as follows.

After the cavity is rehabilitated, a fascine drainage is formed: they take a PVC or silicone tube of the required length, to which shorter tubes are tied without any effort with a thin simple catgut to the required quantity, according to the situation. In total, the drainage must have at least three pipes. Each level of shorter tubes may contain one or more tubes. The formed fascin drainage is placed in the drained cavity with the apex toward its deep part, and with the base towards the skin. The outside of the tube is removed either through the corner of the wound, or through an additional tissue incision (contraperture). Tubes of each level are marked in length, for example, with strips of sticky patch and fixed to the skin with sutures so that the retaining sutures are not broken when the tubes are removed from the longest to the shorter. Permanent or fractional irrigation of the drained cavity is carried out through the longest tube at the moment. Monitoring the process of cavity growth is carried out by dynamic fistulography.

This achieves a consistent closure of the walls of the cavity, its gradual shortening and narrowing, which reduces the time of healing of the cavity, compared with the prototype, and reduces the likelihood of complications.

Information sources

1. Bondarchuk OI, Kadoshchuk T.A. Paired drainage. // Surgery. - 1993. - No. 1. - S. 57.

2. Zatonskikh B.Ya. A two-tubular method for draining the abdominal cavity // Bulletin of Surgery. I.I. Grekova. - 1990. - No. 2. - S. 107-108.

3. Myshkin K.I., Kossovich M.A. Abdominal drainage after cholecystectomy // Bulletin of Surgery. I.I. Grekova. - 1990. - No. 2. - S.108-109.

4. Torgunakov A.P. Fashed drainage. // Bulletin of Surgery. I.I. Grekova. - 1992. - No. 2. - S.240-241.

Claims (1)

A method for the draining of delimited cavities by fascia, including a bundle of solid or perforated tubes of the same length, characterized in that, in order to reduce the time of cavity healing and reduce the development of complications, the length of the tubes in the cavity is reduced stepwise, and they are removed sequentially, starting with the longest and ending the shortest.

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