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Serious infection has been related to the use of suction apparatus and to the suctioning procedure. Prevention of infection focuses on aseptic technique, handwashing, decontamination and sterilization of apparatus where appropriate. This article considers the infection risks arising from use of suction apparatus, the suctioning procedure and sets out recommendations for infection prevention.
This prospective randomised controlled trial aimed to compare the effects of oronasopharyngeal suction with those of no suction in normal, term and vaginally born infants and was performed at a Turkish tertiary hospital from June 2003 to January 2004. A total of 140 newborns were enrolled in the trial (n = 70 per group). The no suction group showed lower mean heart rates through the 3rd and 6th minutes and higher SaO(2) values through the first 6 mins of life (P < 0.001). The maximum time to reach SaO2 of >or= 92% (6 vs. 11 min) and >or= 86% (5 vs. 8 min) were shorter in the no suction group (P < 0.001).
The purpose of this study was to determine the frequency and severity of arterial oxygen desaturation during and after endotracheal suctioning in a group of ventilator-dependent patients with acute respiratory failure (the majority of whom had underlying obstructive lung disease) and to evaluate the efficacy of several maneuvers designed to minimize desaturation. The adaptor method presented obviates both removal from and reconnection to the ventilator during suctioning, as well as the need to alter ventilator settings. It is concluded that on-ventilator adaptor suctioning is a simple and effective measure for minimizing suctioning-related arterial oxygen desaturation.
This a randomized clinical trial in which 20 patients were prospectively evaluated for the incidence of ventilator-associated pneumonia (VAP), of whom 12 received endotracheal suctioning by an open-suction method and 8 by a closed-suction method. Differences in the incidence of VAP was not significantly different (p = 0.4) between closed and open suctioning. Differences in Acute Physiology and Chronic Health Evaluation II, duration of entubation, and the use of steroids were all not significant. All patients in the study used H2 antagonist and a nasogastric tube. Proceeding with the study will involve a sample increase with a possible change in the results.
Four low-vacuum systems and eight high-vacuum systems were examined with special reference to the pressure-volume relations. The maximum filling volume for adequate transport of wound secretion was determined for each type. The use of a synthetic wound fluid instead of water resulted in a smaller aspiration volume. Enlargement of the tube diameter resulted in a reduced initial vacuum for the low-vacuum systems, whereas the high-vacuum systems were not affected. Normal drain tubes were compared with "Ulm drains" and silicon tubes for suction capacity. The suction maximum of normal tubes and silicon tubes was located at the proximal holes of the perforated tubes. The "Ulm drain," with perforation diameter increasing continuously to the distal end of the tube, was found to exert suction even at the more distal part of the tube. It is estimated that this tube allows locally more balanced vacuum in the wound.
By way of introduction the authors deal with the necessity for suction as an important component of ergonomic work organization in dental practice. The technical pre-conditions (suction technique) are indicated. Principles are formulated for their beneficial application in the sense of systematic suction methodics.
A new computerized suction aspirator monitor is described. This device offers the benefits of instantaneous and concurrent scientifically accurate readout of aspirate contents in five separate bodily areas. Thus knowledge of amounts of blood versus fat can be immediately known without resorting to guess, estimate, or cumbersome lipocrit determination by centrifuging. Advantages of such a device include better accuracy in determination of fat removal from each area, with improvement of symmetrical fat removal. More exact determination of blood loss with improved hemodynamic replacement is also more easily and safely accomplished. In an area of mystique, experience, artistry, and aesthetic appreciation which has cloaked the initial enthusiasm for suction lipectomy, a new generation of scientific accuracy is now possible. Thus accurate determination of aspirate content vis-a-vis fat and blood can now transform this procedure into a more sophisticated and scientifically accurate operation which traditionally is desired by most practitioners of suction lipectomy.
In two prospective randomized studies the common drainage system according to Redon was compared with the gravity system according to Robinson in 80 patients undergoing elective knee joint surgery and in 60 patients undergoing total hip replacement. By use of clinical criteria such as output volume and rate of hematomas in both groups no statistically significant difference could be established. However, there is a tendency to a lower hematoma rate in patients with knee joint operations and treated with the Robinson system. On the other hand after total hip replacement a tendency to lower hematoma rate was observed in the Redon group. These differences can be explained by the different output volumes after hip and knee joint operations. Probably the Robinson system cannot drain as much volume as the Redon system. A further explanation could be that after hip replacement an external compression cannot be sufficiently performed compared to the knee joint operations. Furthermore the remaining subfascial cavity after hip replacement should be drained with suction in order to reduce the extent of the cavity. This point of view is supported by the observation that the gravity system seems to be only an overflow one in clinical practice. The main advantage of the Robinson system is the significant lower pain score when removing the drainages and even when the drains are lying in situ. This advantage, however, is possibly a relative one, when the Redon drains are removed without suction. So the postulation that the Robinson system should be generally introduced in orthopedic surgery cannot be accepted. At the moment there are indications for both systems.(ABSTRACT TRUNCATED AT 250 WORDS)
UNLABELLED: Multiple-use (M-U) closed-system endotracheal suction catheters are effective in preventing arterial oxygen desaturation in patients on positive end-expiratory pressure (PEEP) and may lessen the frequency of bradycardia and hypotension in unstable patients who are prone to these complications of suctioning. However, because M-U catheters remain attached to the ventilator circuit and are reintroduced repeatedly into the patient's airway over 24 hours or longer, they could become heavily contaminated with pathogens. We hypothesized a risk of autocontamination to the patient by re-inoculation of the respiratory tract with organisms that flourished on the M-U catheter while it was isolated from the patient's immune defenses or antibiotic therapy. METHODS: We tested this hypothesis in 30 mechanically ventilated adult patients with positive sputum cultures. We measured and compared the amount of bacteria present on an M-U catheter at the end of a 24-hour use period, the amount of bacteria present in the patient's sputum at that time, and the amount of bacteria present on a single-use (S-U) catheter at that time, after it had made one pass into the patient's airway. Organisms recovered and colony counts were also compared to results of a sputum culture obtained before the study began. RESULTS: Fourteen different pathogens or potential pathogens were recovered, in numbers of 2 x 10(1) to 2 x 10(7)colony-forming units. The greatest number of colonies was most often recovered from the sputum specimen, and statistical analysis showed no differences in rate or magnitude of contamination between M-U and S-U catheters.(ABSTRACT TRUNCATED AT 250 WORDS)
The manual syringe method of cleaning endoscopes involves numerous problems, including cross-infection, contamination, wasted time, and employee safety issues. This article describes the development of an alternative system by a nurse entrepreneur for endoscopic cleaning using a suction method. Scientific findings gathered over four years are presented supporting the efficacy and usefulness of this system, the Endo-Suction Cleaning System, also known as the PSK System.
A new technique is described for dressing of surgical wounds in total knee arthroplasty that is a combination of a semi-permeable dressing and suction drainage. This technique has been used in 100 consecutive cases and drainage was collected in 92. The average volume was 198 ml (range 30 to 850 ml). There was no superficial or deep sepsis. Haematoma formation causing moderate soft tissue tension and some patient discomfort was noted in 9 knees. This form of postoperative wound management retains the nursing and hygiene advantages of deep suction drainage, whilst avoiding the patient discomfort and potential complication possibilities associated with deep internal drainage.
Procedures that minimize the resultant scars while achieving comparable results are preferred by patients and greatly enhance their overall satisfaction. Suction mammaplasty--and indeed all short-scar procedures that are performed on the breast, face, and body--rely to variable degrees on harnessing the under-appreciated capability of the skin to shrink or retract. Patients with breast hypertrophy represent a wide spectrum of deformities based on NAC size, shape, and location, skin quality and tone, and breast volume. No one breast reduction technique is ideal for reducing all breasts. Suction mammaplasty represents one of a number of methods of reduction mammaplasty that can be selected according to variations in anatomy, patient desires, and surgeon preference.
The use of suction lipectomy to reduce breast volume is described. The technique applies only to a very limited group of patients whose nipple-areola complexes are normally located and whose enlargement is primarily fibrofatty in nature. Suction mammaplasty can be used as a sole technique in congenital asymmetry or in post-reduction enlargement or asymmetry.
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