Optimizing the Closed Suction Surgical Drainage System

Abstract

Smaller drain reservoirs are more successful in generating a high initial suction than larger reservoirs, especially when the volume of fluid in the drain is relatively low. In all sizes of drains, compressing the sides of the reservoir is a far better technique for establishing negative pressure than pressing the bottom of the drain up toward the top.

How Much Blood Could a JP Suck If a JP Could Suck Blood?

“…Our conclusion supports the recommendations of other studies that bulbs should be emptied more frequently based on bulb filling. Carruthers et al, along with several other groups, have demonstrated similar findings that maximal pressures were generated when the bulb was empty and that negative pressure values decreased with bulb filling. Further supporting our recommendation, Yue et al demonstrated that accuracy of drainage volume decreases at extreme volumes .…”

Preventing Surgical Site Infections Related to Abdominal Drains in the Intensive Care Unit

“…Therefore, when applying compression to the bulb drain, the drain should be fully compressed by squeezing with a fi st to generate negative pressure. 17 …”

“…These pressures were generated by squeezing the drainage bulb with a fi st to the point of full compression. 17 Carruthers et al 17 also explored the suction generated among drains of all sizes by different modes of compression. They compared suction pressure following drainage bulb compression using the squeeze method (compressing the sides of the bulb along its longest axis) and using the bottom-toward-top method (pushing the bottom of the drain toward the top) (see Figure).…”

“…If the amount of drainage has decreased for several days (and a blockage in the drainage catheter has been ruled out by flushing), the color of the output lightens, and the clarity of the drainage improves, communicate these assessment findings to the provider for possible discontinuation of the drainage catheter. 17 Removal of surgical drains as soon as indicated is one of the best ways to prevent infection because bacteria no longer have a direct conduit to the patient's skin or body. 23 …”

“…In a study by Carruthers et al, 17 drain pressures were measured in collection bulbs of various sizes. The study revealed smaller drainage bulbs (100 mL) had greater peak suction pressures at -117.6 mm Hg than did larger drainage bulbs (400 mL), which had peak suction pressures of -71.4 mm Hg.…”