Use of Drains in Surgery: A Review

Durai, Rajaraman; Mownah, A.; Ng, Philip C H

doi:10.1177/175045890901900603

Cited by 68 publications

(51 citation statements)

References 35 publications

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“…The drains are removed when the volume is ≤ 25 ml over a 24-h period (~1 ml/h). 5,6 In our experience, this measurement reflects drainage rates inaccurately. Factors such as the time of completion of surgery and expected accumulation of fluid in the dissected tissue spaces in the immediate postoperative period are not taken into consideration.…”

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confidence: 99%

Postoperative drainage in head and neck surgery

Amir

Morar

Belloso

2010

annals

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INTRODUCTION A major factor affecting patients’ length of hospitalisation following head and neck surgery remains the use of surgical drains. The optimal time to remove these drains has not been well defined. A routine practice is to measure the drainage every 24 h and remove the drain when daily drainage falls below 25 ml. This study aims to determine whether drainage measurement at shorter intervals decreases the time to drain removal and hence the length of in-patient stays. PATIENTS AND METHODS A 6-month prospective observational study was performed. The inclusion criteria were patients who underwent head and neck surgery without neck dissection and had a closed suction drain inserted. Drainage rates were measured at 8-hourly intervals. Drains were removed when drainage-rate was ≤ 1 ml/h over an 8-h period. RESULTS A total of 43 patients were evaluated. The highest drainage rate occurred in the first 8 postoperative hours and decreased significantly in the subsequent hours. The median drainage rates at 8, 16, 24, 32 and 40 postoperative hours were 3.375, 1, 0, 0 and 0 ml/h, respectively. Applying our new removal criteria of ≤ 1 ml/h drainage rate, the drains were removed in 22 (51%) patients at the 16th postoperative hour; 37 (86%) were removed by 24 h after operation. In comparison, only nine (20.9%) patients could potentially be discharged the day after surgery if previous criteria of ≤ 25 ml/24-h were used to decide on drain removal. CONCLUSIONS Our 8-hourly drainage-rate monitoring has facilitated safe earlier discharge of an additional 28 (65%) patients on the day after surgery. This has led to improvement in patient care, better optimisation of hospital resources and resulted in positive economic implications to the department.

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confidence: 99%

Postoperative drainage in head and neck surgery

Amir

Morar

Belloso

2010

annals

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“…The ability to effectively remove fluid more completely could potentially reduce complications traditionally associated with flap elevation and even facilitate patient recovery (Durai, Mownah, & Ng, 2009). The ability to effectively remove fluid more completely could potentially reduce complications traditionally associated with flap elevation and even facilitate patient recovery (Durai, Mownah, & Ng, 2009).…”

Section: Methodsmentioning

confidence: 99%

Optimizing the Closed Suction Surgical Drainage System

Carruthers

Eisemann

Lamp

et al. 2013

Plastic Surgical Nursing

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“…When drainage is employed, it should be efficiently used and removed at the earliest safe time following the surgery. Durai et al suggested that it was relatively safe to remove a drainage tube if the drainage flow was <25 ml within 24 h (20). In addition, drains should be placed carefully to avoid direct contact with the major blood vessels, organs and anastomoses, and should be withdrawn and turned appropriately for a period of time (20).…”

Section: Discussionmentioning

confidence: 99%