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At least 37 records · Page 2Linked to original sources
PubMed1998

Cardiovascular disturbances caused by extradural negative pressure drainage systems after intracranial surgery.

Extradural drainage systems connected to a vacuum device for preventing postoperative haematoma formation are often used in neurosurgical practice. Cardiovascular complications, including bradycardia or low arterial pressure caused by intracranial hypotension, have been described associated with their use. We have investigated the relationship between the negative pressure applied to extradural drainage systems and intracranial pressure (ICP), and analysed the effects of negative pressure of the drains on systolic (SAP), diastolic (DAP) and mean (MAP) arterial pressures and on heart rate (HR). We studied prospectively 15 patients undergoing neurosurgery for supratentorial tumours or aneurysms. Transient decreases in ICP (P < 0.001) and HR (P < 0.001), with no clinical effects, were observed after connecting the vacuum device to the drain. There were no significant changes in SAP, DAP or MAP.

Adult↗
PubMed2005

A hydrodynamic study of pleural drainage systems: some practical consequences.

BACKGROUND: A pleural drainage system must be capable of efficiently evacuating the air or fluids from the pleural cavity so that adequate lung reexpansion can take place. The air flow and negative pressure of the system will depend on the particular design of each model. This experimental study analyzes the specifications and performance of the pleural drainage systems currently on the market. METHODS: Thirteen models of pleural drainage systems connected to wall suction were examined. The models were classified into the following three groups: dry systems; wet systems; and single-chamber systems. We determined the ambient air flow and the negative pressure generated according to the suction level. The components of each model are also described. RESULTS: Under normal conditions, dry (except for the Sentinel Seal; Sherwood Medical; Tullamore, Ireland), wet, and single-chamber systems reach similar air flow rates (17 to 30, 24 to 27, and 22 to 28 L/min, respectively). With higher wall suction levels, wet systems increase the air flow (26 to 49 L/min) but the negative pressure becomes unstable because of the water loss phenomenon, dry systems increase the air flow (29 to 50 L/min) without modifying the regulator pressure, and single-chamber systems also raise the air flow (45 to 51 L/min) but increase the negative pressure. When there is an air leak, dry systems (except for the Sentinel Seal) lose less negative pressure than the other systems. CONCLUSIONS: The functioning of these systems can be optimized only by applying a suitable wall suction level adjusted to each case. Although the three types of systems are capable of evacuating adequate air flow rates, the negative pressure and the capacity to maintain it in the presence of an air leak are different in each system. Being fitted with valves and not water compartments makes the dry systems the safest and the ideal for use when the patient has to be moved.

Biomechanical Phenomena↗
PubMed1975

The corpus cavernosum intercommunicating venous drainage system.

A series of cavernosograms were used to study the corpus cavernosum superficial and deep dorsal venous system. Within this drainage system exists an intricate circumflex venous interconnective network of vessels. In addition, each corpus cavernosum intercommunicates with its opposite corpus cavernosum through median septal apertures. The cavernosum venous system, unlike the venous drainage from the glans penis, delays venous drainage and in doing so assists in maintaining erections.

Adult↗
PubMed1993

Nosocomial catheter-associated bacteriuria: a clinical trial comparing two closed urinary drainage systems.

We compared the time of onset and incidence of nosocomial bacteriuria between two different closed urinary drainage systems: a simple closed drainage system containing an antireflux valve ('Urias A-4') and a complex closed drainage system ('Curity Infection Control System') incorporating: (1) a preconnected, coated catheter, (2) a tamper discouraging seal at the catheter-drainage tubing junction, (3) a drip chamber, (4) an antireflux valve, (5) a hydrophobic drainage bag vent and (6) a povidone-iodine releasing cartridge in line with the outlet tube of the urine collection bag. 181 non-bacteriuric patients, requiring catheter drainage for more than 48 h, were assigned by chance to either of the two systems. Bacteriological monitoring of bladder urines of the enrolled patients was performed every 24 h by establishing viable counts and identification of all microorganisms. No differences in the onset and incidence of nosocomial bacteriuria between the two urine drainage system groups were noted. We conclude that additional complex features aimed at preventing intraluminal spread of bacteria did not reduce the risk of urinary tract infection, compared to a simple closed urinary drainage system.

Adult↗
PubMed1996

Reported blood exposure rates and staff nurse satisfaction with a closed surgical drainage system.

BACKGROUND: The purposes of this investigation were (1) to describe performance characteristics, incidence of exposure, and staff satisfaction with a closed drainage system, the Kendall Tru-Close, and (2) to compare performance, incidence of exposure, and satisfaction between the closed drainage system and a currently used surgical drainage system (the Hemovac). METHODS: Subjects were 40 adult male and female patients who had undergone selective orthopedic joint surgery. Twenty patients received the Hemovac drainage system, and 20 patients received the Tru-Close drainage system. Data collection instruments included a patient demographic data form, a daily assessment form, a nurses' bedside survey (self-report), and a satisfaction questionnaire. RESULTS: There were significantly fewer exposures with the closed drainage system when compared with the Hemovac system. An odds ratio of 5.09 indicated that the odds of exposure to fluids with the Hemovac system were five times greater than for the closed system. Nursing satisfaction scores were higher for the Tru-Close system than the Hemovac system for items that related to protection from exposure to self or environment. However, overall nursing satisfaction with the new device was mixed. CONCLUSIONS: Although nurses liked the increased protection from exposure afforded by the Tru-Close drainage system, other patient management issues emerged related to the increased weight of the reservoir bag.

Adult↗
PubMedDate not supplied

[Weaknesses of conventional drainage systems].

Of the different drainage systems the high vacuum technique according to Redon is the procedure of choice for orthopaedic and trauma surgery. Overflow drainage should be restricted to certain special indications, when there is a risk for high blood loss. Open drainage doesn't fulfill the high sterility demands, we require in orthopaedic surgery. Aside from the positive wound healing effects, high vacuum drainage according to Redon hides some risks for complications, which aren't well known by surgeons. All openings of the drainage lines, the change of suction container as well, may lead to a reflux and thus cause retrograde wound contamination. By this procedure also aerosol formation was found, which may represent risks for the ward personnel. Changes of the suction container must have an indication and should only be performed in the presence of a blocking device at the connection tube. The vacuum indicators of most products on the market need further improvement, in order to enhance the operating safety.

Bacterial Infections↗
PubMed1992

Lacrimal drainage system injury in functional endoscopic sinus surgery. Incidence, analysis, and prevention.

Injury to the lacrimal drainage system with resultant epiphora is a complication of functional endoscopic sinus surgery. A study of 24 patients was conducted to determine the incidence and significance of lacrimal drainage system injuries during functional endoscopic sinus surgery. Intraoperative testing demonstrated seven occult injuries (15%) in 46 endoscopic procedures. Postoperative testing demonstrated diversion of lacrimal drainage into the middle meatus in two patients and spontaneous healing of the injured lacrimal drainage system with restoration of normal drainage in three of the patients available for follow-up testing. In no patient did epiphora develop. It is concluded that the nasolacrimal drainage system is in close proximity to the dissection cavity during functional endoscopic sinus surgery and, hence, is at risk for inadvertent injury. Occult damage to the nasolacrimal drainage system would appear to be a common event during functional endoscopic sinus surgery; however, the complication of postoperative epiphora is rare.

Child↗
PubMed1988

Comparison of four urine drainage systems.

An evaluation of four urine drainage systems available for use by patients with indwelling urethral catheters and prescribed by general practitioners was performed. Twenty-four patients in the community of one health district tested each system for a number of weeks. Both users and carers responsible for the management of the urine drainage system tested their acceptability and reported on preference, methods of support, ease of use and comfort. The significance of the results and their implications for nursing are discussed.

Aged↗
PubMed1982

Dangers of collapsible ventricular drainage systems. Technical note.

Ventricular drainage systems employing a collapsible plastic bag for fluid collection were postulated to cause an increasing back-pressure produced in part by the elasticity of the bag. This postulate was shown to be correct in an experimental situation. There was a logarithmic rise in cerebrospinal fluid pressure as the bag filled. By increasing the size of the bag, the problem was overcome.

Cerebral Ventricles↗
PubMed2004

Trauma of the lacrimal drainage system: retrospective study of 32 patients.

AIM: To assess retrospectively the results and complications of surgical techniques applied in the treatment of patients with trauma of the lacrimal drainage system. METHODS: Out of 32 patients with lacrimal drainage system trauma included in the study, 25 were treated at the University Eye Clinic, Ljubljana Medical Center, Ljubljana, Slovenia, from 1999 to 2003, and 7 were referred for secondary repair from other health care institutions in the same time period. All patients with fresh injuries underwent surgery within 48 h. The patients were followed up to a year after surgery. We evaluated the function of the lacrimal drainage system by irrigation at the last follow-up visit. RESULTS: Patent lacrimal drainage system was achieved in all 25 patients with primary reconstruction of the injury. Restenosis of the canaliculus occurred in 4 out of 7 patients after secondary reconstruction. CONCLUSIONS: Early repair of the lacrimal drainage system eliminates complications in comparison with secondary repair. Repair of the lacrimal drainage system may be delayed for up to 48 h, if an experienced operating team is available.

Dacryocystorhinostomy↗
PubMed2006

Changes in lumen width of nasolacrimal drainage system after adrenergic and cholinergic stimulation.

PURPOSE: To determine the effect of an adrenergic agonist and a cholinergic agonist on the lumen width of the nasolacrimal drainage system. DESIGN: Prospective, nonrandomized, clinical trial. METHODS: The asymptomatic sides of 33 patients (23 women, 10 men) with unilateral stenosis/obstruction of the nasolacrimal drainage system were studied. The tear meniscus height of the asymptomatic side was normal, with a patent lacrimal system as revealed by dacryocystography. The nasolacrimal drainage system of the asymptomatic side was infused with 100 microL of 5% phenylephrine hydrochloride (an alpha-1 adrenoceptor agonist) or 100 microL of 2% pilocarpine hydrochloride (a cholinergic agonist), and dacryocystography was performed to determine the lumen width of the nasolacrimal drainage system. RESULTS: Phenylephrine caused a significant increase of the lumen width of the nasolacrimal drainage system, and the changes were more marked in the nasolacrimal duct (NLD), especially the upper and middle regions, than in the lacrimal sac. In contrast, pilocarpine reduced the lumen width of the NLD significantly, especially in the middle and lower regions, and the lumen width of the lacrimal sac was not significantly changed. CONCLUSION: The alterations of the lumen width of the nasolacrimal drainage system, especially the lumen width of the NLD by adrenergic and cholinergic agonists, suggest that the lumen width can be changed by the autonomic nervous system.

Adrenergic alpha-Agonists↗
PubMed1984

Septic complications of percutaneous transhepatic biliary drainage. Evaluation of a new closed drainage system.

In a consecutive study of 49 patients with obstructive jaundice who underwent preoperative percutaneous transhepatic drainage, the incidence of bacteria in bile at the time of insertion of the drainage catheter was 29 percent. Patients drained with a conventional open drainage system showed an increase to 100 percent positive cultures after 20 days drainage. In this group, there was also a high incidence of episodes of bacteremia preoperatively and postoperatively and a high incidence of positive wound cultures. An antiseptic barrier incorporated into the drainage system reduced the incidence of positive bile cultures during the drainage period although this did not afford a significant reduction in bacteremic episodes and positive wound cultures. Using a new closed drainage system, the acquisition of environmental organisms to the bile was eliminated which allowed a significant reduction in septic complications both preoperatively and postoperatively. This new closed drainage system increased the value of preoperative decompression of the obstructed biliary tree by preventing exogenous bacterial contamination and reducing associated septic episodes.

Bacterial Infections↗
PubMed2003

[Eye-associated lymphoid tissue (EALT) is continuously spread throughout the ocular surface from the lacrimal gland to the lacrimal drainage system].

INTRODUCTION: Components of the mucosal immune system (MALT) have been identified in the conjunctiva (as CALT) and the lacrimal drainage system (as LDALT). Their structural and functional relation with the established immune protection by the lacrimal gland is unclear. MATERIAL AND METHODS: Macroscopically normal and complete tissues of the conjunctiva, lacrimal drainage system and lacrimal gland from human body donors were investigated by analysis of translucent whole mounts, and using histology, immunohistology as well as scanning and transmission electron microscopy. RESULTS: A typical diffuse lymphoid tissue, composed of effector cells of the immune system (T-lymphocytes and IgA producing plasma cells) under an epithelium that contains the IgA transporter SC, is not isolated in the conjunctiva and lacrimal drainage system. It is anatomically continuous from the lacrimal gland along its excretory ducts into the conjunctiva and from there via the lacrimal canaliculi into the lacrimal drainage system. Lymphoid follicles occur in a majority (about 60%) and with bilateral symmetry. The topography of CALT corresponds to the position of the cornea in the closed eye. CONCLUSION: These results show that the MALT of the lacrimal gland, conjunctiva and lacrimal drainage system constitute an anatomical and functional unit for immune protection of the ocular surface. Therefore it should be integrated as an "eye-associated lymphoid tissue" (EALT) into the MALT system of the body. EALT can detect ocular surface antigens by the lymphoid follicles and can supply other organs and the ocular surface including the lacrimal gland with specific effector cells via the regulated recirculation of lymphoid cells.

Aged↗
PubMed1991

Bacteriologically stressed animal model of new closed catheter drainage system with microbicidal outlet tube.

We have used a catheterized rabbit model to test a newly developed catheter drainage system that incorporates a microbicidal outlet tube. In these tests, this new system was compared with a currently marketed closed drainage system, with daily challenge at the outlet tube using an auxotrophically marked uropathogenic strain of Escherichia coli. In the control series (silicone catheter connected to a standard drainage bag via a tamper-evidence seal) the challenge organism developed upstream biofilm colonization of the luminal surfaces of the catheter and drainage system that was complete in 4.6 +/- 2.1 days in 11 animals, while in 1 animal a rapid overgrowth of the system with Streptococcus faecalis developed. The presence of organisms other than the marked E. coli strain on the luminal surfaces of these control catheters showed that down stream colonization was also operative. In the test catheter drainage series, the microbicidal outlet tube insert precluded upstream colonization by the challenge organism in 12 of 16 catheters and significantly delayed (7.2 +/- 1.0 days) this colonization in the remaining 4 animals. When upstream colonization by exogenous bacteria was precluded by this effective device, downstream colonization of the drainage system by mixed populations of bacteria that probably migrated into the bladder via the extraluminal urethral route developed in some animals (6 of 16).

Animals↗
PubMed1996

Exposure risks related to the management of three wound drainage systems.

BACKGROUND: In response to the Occupational Safety and Health Administration regulations and Centers for Disease Control and Prevention guidelines, health care employers must explore and incorporate new methods to protect staff and patients from blood-borne pathogens. An area directly affected by the new OSHA standards is the postoperative management of surgical drainage systems. This study compared three surgical wound drainage systems: a "closed" system (Tru-Close) and two currently used drainage systems (Hemovac, and Mini-Snyder) for nursing practices and risk of exposure to blood or body fluids in a simulated setting. METHODS: Fifty-eight volunteer registered nurses were asked to choose appropriate personal protection equipment and use recommended universal precautions while measuring and emptying fluid and reactivating each of the drainage systems and to complete a satisfaction questionnaire. Each postoperative wound drainage system was filled with simulated wound drainage and connected to a manikin in an empty patient room. Exposure/contamination was defined as spilling, dripping, or splashing of simulated drainage fluid anywhere in the patient's room or bathroom. RESULTS: Forty-five percent of nurses who emptied bulb evacuator systems and 40% of nurses who emptied Hemovac systems had resulting contamination to the environment or exposure to self. There were no contaminations with the Tru-Close system. Most contaminations were droplets of fluid on environmental surfaces rather than on the nurses themselves. Most nurses chose gloves for personal protection regardless of the system used. Gowns and face shields were rarely used. Most contaminations were due to emptying simulated fluid (27%) or emptying rinse water (29%) into the patient's toilet. Twenty-three percent (23%) of contaminations occurred while simulated fluid was poured into a container at the bedside. The most common object contaminated was the toilet seat (67%). The bed linen was contaminated 16% of the time. Nurse's gloves were exposed in 6% of the trials. CONCLUSIONS: As administrators and researchers explore new methods to protect patients, health care providers, and the environment from blood-borne pathogens, changes should be balanced with the impact on patient care and user satisfaction.

Adult↗
PubMed2002

High-pressure gradients generated by closed-suction surgical drainage systems.

BACKGROUND: Closed suction drains remain in widespread use in surgical practice. There have been reports of complications associated with their use. We sought to characterize the pressure-generating capacities of three commonly used closed suction drainage systems. MATERIALS AND METHODS: Three commonly used closed suction surgical drainage systems were studied: Davol Reliavac 400 Evacuator, Jackson-Pratt Closed Wound Suction Drainage System, and Snyder Hemovac 400. Each drainage system was connected to a pneumatic pressure transducer, and pressure measurements were made. Measurements were made with the drain reservoirs at varying degrees of fullness. Measurements were also made while "stripping" the drains. RESULTS: In all three systems, maximal negative pressures (-71 to -175 mm Hg) were generated with the reservoirs empty of fluid. Pressure generation by all drains decreased as the volume of fluid in the reservoir increased. In all cases, drain "stripping" was associated with a transient elevation in drain pressure (p<0.05). In two out of three drains, stripping led to a significant residual increase in static drain pressure. CONCLUSION: Closed suction drains are capable of generating high pressures that may contribute to some complications associated with their use. Closed suction drainage systems differ with regard to their generation of negative pressure.

Drainage↗
PubMed1997

The relationship of preoperative magnetic resonance imaging findings and closed system drainage in the recurrence of chronic subdural hematoma.

Although chronic subdural hematoma (CSDH) is a well-known entity, its recurrence rate has remained uncertain. There is little knowledge concerning whether the results of radiological imaging can be used to predict CSDH recurrence or whether surgical methods can influence this rate. The first aim of this study is to evaluate the relationship between the recurrence rate of CSDHs and their appearance on preoperative magnetic resonance (MR) or computerized tomography images. The second aim is to evaluate by means of a prospective randomized method the usefulness of closed-system drainage. From January 1988 through June 1996, the authors surgically treated 257 consecutive adult patients with CSDHs. Data obtained in 199 patients who were evaluated preoperatively by MR imaging were analyzed. Thirty-one of these patients underwent bilateral operations and thus 230 operative sites of CSDH were included in the analyses. The cases of CSDH were separated into high- and nonhigh-intensity groups on the basis of the appearance on T1-weighted MR images. From July 1992 to June 1996, the authors conducted a prospective randomized study on the recurrence rate of CSDH in patients undergoing burr-hole irrigation with or without closed system drainage. The recurrence rate of 3.4% in the high-intensity group was significantly lower than the 11.6% rate found in the nonhigh-intensity group (p < 0.05). The recurrence rates following irrigation with and without closed system drainage were significantly different (p < 0.025): 3.1% with closed system drainage and 17% following burr-hole irrigation alone. The surgical procedures were correlated with the MR findings. In the high-intensity group, 1.1% of CSDHs recurred in patients in whom closed system drainage was used and 11.1% in patients without closed system drainage. In the nonhigh-intensity group, 8.1% of CSDHs recurred in patients in whom drainage was used and 23.1% in patients without closed system drainage. Magnetic resonance T1-weighted imaging was useful in predicting the propensity of CSDHs to recur. Closed system drainage significantly reduced the recurrence rate of CSDHs regardless of MR findings.

Adult↗