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At least 19 recordsLinked to original sources

[Slit drainage versus Redon drainage in a clinical comparison--initial experiences with a new kind of wound drainage system].

In a prospective, randomised study we compared the clinical properties of the established Redon drain with a new type of drain called "slit drain". Both types of drains were examined regarding the amount of drained fluid, the time elapsing until removal of the drain, the frequency of occlusion of the lumen as well as the patient's pain and the required force at extraction of the drain. The statistical analysis showed both drains to have equal abilities in draining of fluid if they were used under vacuum conditions. If used as nonsuction drains, the new device was able to drain more fluid than the established type of drain (p less than 0.05). Statistically relevant advantages of the slit drain were seen in a lower rate of obstruction of the lumen, a higher amount of drained fluid (as non-suction device) as well as an easier and less painful extraction.

Breast Neoplasms

Percutaneous catheter drainage compared with internal drainage in the management of pancreatic pseudocyst.

The records of 92 patients with symptomatic pancreatic pseudocysts referred for surgical management over a 27-year period were retrospectively reviewed to compare outcome in 42 patients managed with operative internal drainage procedures (group I) with that in 52 patients managed with computed tomography-directed percutaneous catheter drainage (PCD) (group II). The two groups were similar for patient age, sex, pseudocyst location, and cause. The frequency of antecedent pseudocyst-associated complications was less in group I (16.7 versus 38.5%, p less than 0.05). Seven group I patients and four group II patients had major complications (16.7 versus 7.7%, not significant). Group II mean duration of catheter drainage was 42.1 days, and the drain track infection rate was 48.1%. The frequency of antecedent operative cyst drainage was similar (14.2 versus 13.5%), as was the frequency of subsequent operations for complications related to chronic pancreatitis (9.5 versus 19.2%, not significant). Mortality rate was greater in group I (7.1% versus 0%, p less than 0.05). Pseudocysts can be effectively managed either by open operation with internal drainage or by PCD. Drawbacks of PCD include the controlled external pancreatic fistula and the risk of drain track infection. Percutaneous catheter drainage has the following advantages: (1) low mortality rate, (2) does not require a major operation, (3) does not violate the operative field in cases when subsequent retrograde duct drainage procedures are required. Neither PCD nor internal drainage is definitive, and with either technique subsequent correction of underlying pancreatic pathology may be necessary.

Adult

[Clinical use and comparative study of Ulmer drainage and of the usual Redon tissue drainage].

After discussing the shortcomings of the usual Redon drainages and the description of our own technique of vacuum-tissue suction drainage, there follows a report about a comparative examination between Redon drainages and the new 'Ulmer drainage'. Up to now the superiority of the Ulmer drainage was proven only by calculation and experiment, now this fact can be fully confirmed by a succession of clinical examinations. By inserting both types of drainages in one surgical wound, the Ulmer drainage delivered on the first day 1.5 times; on the second and third day, almost 2.5 times the amount of secretion compared with the usual Redon drainage.

Clinical Trials as Topic

[What suction drainage is optimal for drainage of wound secretion? A clinico-experimental study exemplified by the knee joint].

In a randomized clinical study on 40 intraarticular knee joint drainages the effect of a high vacuum, middle vacuum, low vacuum and suction free drainages were examined. The maximum of the volume that was drained had been in the group of the suction free drainages. Drains with a long period of suction had a minimum of evaluated ultrasonographic effusion in the knee joint. The group with high vacuum was obviously not as long as open as in the other groups. Thrombi in the drainages could be found in every group. This refers to the observation that the finding of adherent thrombi is related to the material the drain is made of. Adherent thrombi decrease the possibility of secretion, not adherent thrombi do not decrease suction volume. Referring to these results it is obvious that not the high-vacuum drainage is the matter of choice for intraarticular drains. The suction-free drainages or drains with reduced vacuum have more advantages in respect to simple, secure and fast implantation and handling.

Equipment Design

A closed irrigation and drainage system for use with percutaneous abscess drainage: technical note.

A closed irrigation and drainage system has been used in 50 consecutive patients to assess its effectiveness in maintaining catheter patency and draining fluid collections. It consists of an irrigation fluid source, flushing syringe, drainage bag, and tubing to connect the components, and is assembled when the initial drainage procedure is performed. The system emphasizes the use of the siphon effect to maintain constant suction and a closed irrigation and drainage configuration that prevents spread of infection to others and minimizes contamination of the drained cavity. This method of irrigation and drainage also makes patient care considerably easier, and ensures catheter patency.

Abscess

Biliary-jejunal drainage for failed biliary-duodenal drainage.

Percutaneous biliary drainage, as palliation for malignant biliary obstruction, is subject to complications, particularly blockage of the drainage tube. Blockage may occur because of duodenal tumour involvement. In nine patients with blockage of the biliary-duodenal drainage tube, conversion to biliary-jejunal drainage allowed continued internal drainage of bile.

Aged

[Technic of pleural drainage (emergency pleural drainage)].

Pleural effusion is still often poorly drained: - incorrect introduction of the drain into the thorax, - ill-chosen position of the drain. Simple drainage, a minima, is considered here, that which requires no broad surgical incision and which, in cases of effusion with compression of the lung, is often a life saving procedure which any doctor should be able to carry out, especially if he deals with emergencies. The surest technique consists of placing a No. 30 drain, using a pleurotomy trocart, type Monod or Coquelet, under local anaesthesia. Introduction of the drain using a forceps after an incision with the scalpel blade is only justified if one has no trocart available. So-called disposable drains, mounted on a pointed bevelled needle prepared in advance, are practical but dangerous. Capillary drainages are methods of second choice. They are often excluded within short delays. The efficacy of the drainage depends on its position.

Anesthesia, Local

[Slit drainage--progress in drainage treatment after herniotomy].

In a prospective randomized study was conducted on 80 patients undergoing elective hernia repair to assess whether a new slit-suction drainage is less painful than a Redon-suction drainage. Main endpoint of the study was the traction power in order to remove the drain. Other endpoints were pain at the time of removal of the drain and the effectiveness to draw off secretion. To remove redon drain the average traction power was 226 pond and to remove slit drain the average traction power was only 25 pond. The difference was significant (p less than 0.01). At the time of removal patients with slit drain rarely complained about pain (p less than 0.01). On contrary, patients with Redon drain always complained about pain. Clotting were seldom shown in slit drains and were frequently shown in redon drains. Both slit drains and redon drains were effective to drain secretion. As the new slit drain was more comfortable for patients following hernia repair slit drain should always be used as subcutaneous suction drainage.

Drainage

Percutaneous catheter drainage for acute empyema. Improved cure rate using CAT scan, fluoroscopy, and pigtail drainage catheters.

Percutaneously inserted pigtail nephrostomy catheters were used to treat empyemas in 12 patients. Thoracic computed tomographic (CT) scan and fluoroscopy were used to localize precisely and place the catheters into loculated collections of fluid. Percutaneous catheter drainage (PCD) of empyema was successful in seven of seven patients (100%) in whom standard tube thoracostomy (STT) had initially failed and in three of five patients (60%) who had PCD as the initial drainage procedure. Overall, PCD was successful in treating empyema in ten of 12 patients (83%). The procedure was well tolerated and there were no complications. PCD is a safe and effective method for drainage of loculated empyemas as the initial procedure or after STT has failed.

Acute Disease

[Studies on the lymph drainage of the eye. 1. Quantitative registration of the lymph drainage from the orbita of the rabbit with radioactive tracers (author's transl)].

For the investigation on the lymph drainage from the orbita 99mTc-microcolloid, 99mTc-albumin and 198Au-colloid have been injected into the retrobulbar space of 24 rabbits. Measurements of the activity's distribution have been made in vivo with an Anger type camera (pho-Gamma-IV Hp, Searle Nuclear Chicago) and in vitro after section with a sodium iodine crystal well counter (Clinimat-200, Picker). A significant concentration of the activity could be observed for the most part in the equilateral Lymphonoduli cervicales profundi and superficiales and for the less part also in the equilateral Lymphonoduli mandibulares and contralateral Lymphonoduli cervicales profoundi. Furthermore significant activities could be pointed out in the optic nerves as well as in the contralateral retrobulbar space. The data substantiate a lymph drainage from the orbita as well as a partly reverse "prelymphatic-lymphatic" flow and are of importance for discussions about lymphostatic ophthalmopathy and sympathetic ophthalmitis. For application on man 99mTc-microcolloid (Lymphoscint) shoud be preferred, because with this tracer 1. the lymph drainage can be measured quantitatively quite exactly by extern measurement with the Anger-camera, 2. the allowable radiation dosis for the lens is lying between 0.5-1.0 rad/mCi.

Animals

[Studies of the lymph drainage of the eye. 4. Drainage of lymphotropic radioactive tracers (99mTc-Microcolloid) after intravitreal injection (author's transl)].

In 7 rabbits the drainage of 99mTc-labelled Micro-colloid from the vitreous body of the eye was studied. In vivo measurements with an Anger-type camera were undertaken as well as in vitro measurements after dissection and excision of tissue-probes. From the data followed that indicator's elimination half-life from the vitreous body was on an average 7.8 hours. The drainage occurred partially along structures which are associated to the optic nerve. Furthermore drainage to the ipsilateral retrobulbar space and to the regional cervical lymph nodes, mainly to the bilateral deep cervical lymph nodes could be observed.

Animals

Pleural effusion in cancer patients. A prospective randomized study of pleural drainage with the addition of radioactive phsophorous to the pleural space vs. pleural drainage alone.

Sixty-seven patients with disseminated cancer were randomly allocated to treatment with continuous closed chest drainage removing all fluid for 72 hours (PD) or pleural drainage for 72 hours with the instillation into the pleural space of radioactive colloidal chromic phosphate (PD + 32P). Forty-nine patients had breast carcinoma, and the remaining 18 patients had other cancers. Four of 49 patients with breast cancer and 13 of 18 with other cancer were dead in 8 weeks from the onset of effusion. In the group of patients with breast cancer PD + 32P controlled the effusion in 12 of 22 (54%) and PD alone in 15 of 30 episodes (50%). In the nonbreast group of patients PD + 32P controlled the effusion in five of six evaluable episodes (83%), and PD alone was successful in two of nine (22%). In 33% of breast cancer patients and 25% of the nonbreast-cancer patients, systemic chemotherapy produced objective remissions. Pleural effusion did not recur in any of these patients.

Adult

Percutaneous drainage of 335 consecutive abscesses: results of primary drainage with 1-year follow-up.

Retrospective review of percutaneous abscess drainage (PAD) of 335 abscesses in 323 consecutive patients was undertaken. Particular attention was directed to body location, associated organ system, communications and fistulae, and to the underlying immunologic status of the patient. One-year follow-up was available in all patients. Overall, the cure rate was 62.4% (209 of 335 abscesses), with a failure rate of 8.95% (30 of 335 abscesses). There were 14.2% (46 of 323 patients) deaths in the follow-up period, of which 4.6% (15 of 323 patients) were believed attributable to sepsis or septic complications. The overall complication rate was 9.8% (33 of 335 abscesses), most of which were minor in nature. For the patient exhibiting immunocompromise, representing 53.1% (172 of 323 patients) of the patient population, the cure rate was 53.4% (95 of 178 abscesses), which was significantly lower than the cure rate of 72.6% (114 of 157 abscesses) for the immunocompetent patient population (n = 151) (P less than .001). The recurrence rate was 2.1% (seven of 335 abscesses), with all recurrences within 3 months of initial drainage. PAD is effective and permanent treatment for both immunocompromised and immunocompetent patients.

Abscess

[Drainage of the thoracic duct and changes in myocardial lymph drainage under conditions of electrothermocoagulation of the coronary artery].

It was demonstrated in dog experiments that the drainage function of the heart lymphatic system and coagulation of the central lymph are disturbed in acute myocardial infarction. Drainage of the thoracic duct with diversion of the flow of the toxic lymph fails to correct the diminished rate of lymph flow in the myocardium and does not prevent the increase of the hypercoagulation shift in the lymph. It is concluded that lymph stimulation and correction of the disorder of the lymph coagulation potential are necessary for effective pathogenetic treatment of myocardial infarction.

Animals

[Acute hemorrhagic pancreatitis--extended abdominal drainage and perirenal drainage links].

Acute haemorrhagic pancreatitis, when mainly situated in the body and tail of the pancreas, may be associated with abscess formation in the left perirenal region through the radix mesosoli transversi. Next to the extensive drainage of the abdomen and pancreas, we advise supplementary primary left perirenal-retroperitoneal drainage, considering how difficult it can be to loalize a secondary postoperative pancreatic abscess, especially when a computer-assisted tomography (CAT) is unavailable. In those cases in which the transverse colon had suffered circulatory damage from the acute pancreatitis, good results have been obtained with temporary coecostomy.

Adult

[Gravity suction drainage--an alternative to suction drainage in trauma surgery? A prospective randomized comparison in knee operations and hip joint alloarthroplasty?].

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)

Adolescent

Closed catheter drainage and urinary infection--a comparison of two methods of catheter drainage.

The incidence of urinary infection following urological operations is compared using 2 methods of closed catheter drainage in 214 patients. No significant difference was observed. The overall infection rates for the whole series were 32%. The most significant influence on the rate of infection appears to be the duration of catheter drainage. Failure of chemotherapy to eradicate infection while the catheter was still in situ was mostly due to the use of inappropriate antimicrobials. Only 2 of the 35 cases with infected urine had succeeded in clearing their infection at the 4-week follow-up without chemotherapy.

Adolescent

[Studies on the lymph drainage of the eye. 2. Drainage of lymph-dependent radioactive substances from the anterior chamber. (author's transl)].

In order to study lymph drainage from the eye colloid solutions (198Au-colloid and 99mTc-sulfur-colloid) were injected into the right anterior chamber of the eye in 12 rabbits. The distribution of the radioactivity was measured in vivo with an Anger-type camera and in vitro with a sodium iodine crystal well-counter after dissection. The drainage of radioactivity from the anterior chamber had an average half-life of 36 min. The drained activity could be found mainly in blood, liver, kidney, and bone tissue. Moreover, a concentration of radioactivity significantly surpassing the concentration in blood was measured in the right retrobulbar space in 75% of the cases and in the cervical lymph nodes in 50% of the cases. These findings substantiate a communication between the anterior chamber of the eye and the retrobulbar space in the form of a lymphatic or a prelymphatic-lymphatic flow.

Animals