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At least 523 records · Page 29Linked to original sources
PubMed1998

Is suction drainage necessary after total joint arthroplasty? A prospective study.

A prospective evaluation of 98 patients who had undergone a total hip or knee arthroplasty was conducted to assess the effect of postoperative suction drainage. Sixty-six patients undergoing elective total hip arthroplasty and 32 patients undergoing total knee replacement were randomly allocated to undergo either suction drainage or no drainage of the wound. Statistical analysis of the results showed no difference in wound healing, severity of wound haematoma, postoperative blood transfusion requirement, range of motion and duration of the hospitalization between the two groups. We conclude that the use of closed suction drainage provides no apparent advantage after uncomplicated total hip or knee arthroplasty.

Adult↗
PubMed2004

The role of closed-suction drainage in preventing epidural fibrosis and its correlation with a new grading system of epidural fibrosis on the basis of MRI.

In this study we aimed to evaluate the role of closed-suction drainage on the extent of epidural fibrosis (EF) after lumbar disc surgery and to define a new grading system of epidural fibrosis in these patients, based on magnetic resonance imaging. Seventy-nine patients (34 women, 45 men) with a unilateral, single-level lumbar disc herniation were included in this study. Forty-one patients in whom closed-suction drainage was implanted were compared with 38 patients in whom the drain was not implanted. We have used a new grading system for the extent of epidural fibrosis, on the basis of follow-up magnetic resonance imaging findings. Pain intensity was evaluated by visual analog scale (VAS), and the patients' function and working ability were measured according to the Prolo functional-economic scale. We conclude that, in patients operated on for unilateral, single-level lumbar disc hernias, implantation of closed-suction drainage into the operation site results in less formation of EF radiologically and yields better clinical outcome.

Adult↗
PubMed2003

Off-pump multivessel revascularization: efficacy of suction type of coronary stabilizer.

OBJECTIVE: Off-pump coronary artery bypass grafting (CABG) has come into widespread use with the availability adequate coronary stabilization devices. We studied the efficacy of second-generation coronary stabilization devices (suction device) comparing to the first-generation device (compression device). METHODS: We prospectively analyzed consecutive patients who underwent isolated off-pump CABG via a midline sternotomy at Shin-Tokyo Hospital Group between July 1, 1996, and August 31, 2000, comparing perioperative, and follow-up data in the group using a suction device (group S) to that in the group using a compression device (group C). RESULTS: Preoperative risk factors were identical between the two groups, with the exception of a higher incidence of three vessel disease in group S. Complete revascularization increased from 47.3% in group C to 88.1% in group S, and the number of distal anastomoses from 2.1 +/- 0.6 in group C to 2.9 +/- 0.9 in group S. Revascularization of the circumflex artery was achieved in 21.7% of group S patients, which was significantly higher than that in group C (2.2%). Postoperative recovery, mortality, and morbidity did not differ significantly between groups. Calculated event-free rates at 2 years was 88.7% in group C and 92.0% in group S (p = NS). CONCLUSIONS: Anastomosis to the posterior wall of the heart using the suction device is safe. An increased number of distal anastomoses may reduce the occurrence of cardiac events related to incomplete revascularization.

Aged↗
PubMed2003

Prolonged application of closed in-line suction catheters increases microbial colonization of the lower respiratory tract and bacterial growth on catheter surface.

BACKGROUND: Microorganisms become attracted to polymer surfaces for a number of reasons including positive charge of biomaterial or concentration of nutrients on the biomaterial surface. Many bacteria additionally possess specific receptors for the interaction with extracellular host protein components that adhere on the biomaterial surface. Several authors suggest that application of closed in-line polypropylene suction catheters (CISC) in intubated patients for more than 24 h is safe and can reduce the costs associated with mechanical ventilation. Therefore, we evaluated the possible role of prolonged application of CISC to cause enhanced colonization of both the biomaterial and the lower respiratory tract. MATERIALS AND METHODS: The prospective, randomized study included 23 mechanically ventilated patients. The CISC tips, adjacent segments and tracheobronchial aspirates of each patient were examined for microbial growth. RESULTS: Application for 72 h significantly enhanced the microbial growth on the CISC tips and on the adjacent catheter segment. Usage for 3 days led to a significant increase in colonization in the lower respiratory tract. CONCLUSION: Normal saline instillation in conjunction with endotracheal suctioning may lead to a dispersion of microorganisms into the lower respiratory tract. More effective self-cleaning mechanisms are necessary to decontaminate the CISC surface after suctioning.

Bacteria↗
PubMed1984

A bacteriologic study comparing closed suction and simple conduit drainage.

A simple experimental study was designed to determine if closed suction drainage reduces the migration of pathogenic bacteria along a drain tract. Sixty New Zealand rabbits, equally divided into three groups, were splenectomized through midline incisions. Group I served as the control group and received no drainage. Groups II and III had drainage of the splenic bed with simple latex conduit drains (Penrose drains) and closed suction drains (Jackson-Pratt drains), respectively. The skin near the drain exit site was inoculated with a Streptococcus organism. The animals were sacrificed after 72 hours, and intraperitoneal culture specimens were obtained. None of the control rabbits had positive cultures on intraperitoneal specimens. Eighteen of 20 rabbits (90 percent) in Group II (Penrose) had positive cultures on specimens from the splenic bed, whereas 75 percent had positive cultures on drain specimens. Only 4 of 20 (20 percent) of the Group III rabbits had positive cultures on the drain or splenic bed specimens. This difference was statistically significant by chi-square analysis (p less than 0.001). Retrograde migration of bacteria along a drain tract does occur with relatively high frequency with simple conduit drainage and is significantly less with closed suction drainage.

Animals↗
PubMed1987

Closed-suction versus Penrose drainage after cholecystectomy. A prospective, randomized evaluation.

Closed-suction drainage was compared prospectively to open, passive drainage (Penrose drains) in 128 patients undergoing cholecystectomy. Patients were randomized at the time of operation to receive either closed-suction drains (Group I, 67 patients) or Penrose drains (Group II, 61 patients). The preoperative clinical parameters of the two groups were similar. The patients in Group I when compared with those in Group II had a shorter duration of drainage (3.3 days and 4.1 days, respectively, p less than 0.01), a lesser volume of drainage in the first 48 hours postoperatively (78 ml and 132 ml, respectively, p less than 0.001), a decreased incidence of fever on the night of operation (24 of 67 patients and 39 of 61 patients, respectively, p less than 0.05) and on the first postoperative day (26 of 67 patients and 32 of 61 patients, respectively, p less than 0.05), and a lower leukocyte count on the first postoperative day (12,000 cells/mm3 and 14,100 cells/mm3, respectively, 0.05 less than p less than 0.1). Patients in Group I tended to have a lower rate of wound infection (1 of 67 patients versus 5 of 61 patients in Group II, 0.05 less than p less than 0.1) and had a much lower incidence of drain site tenderness (8 of 67 patients in Group I versus 24 of 61 patients in Group II, p less than 0.05). This study demonstrates the superiority of closed-suction drains over open, passive drains after cholecystectomy.

Cholecystectomy↗
PubMed1995

Injury to the common iliac artery during suction rectal biopsy.

A case of injury to the common iliac artery during suction rectal biopsy is described. Factors that might influence the incidence of complications after suction rectal biopsy are considered. Suction rectal biopsy, although invaluable in establishing the diagnosis of Hirschsprung's disease, is a potentially dangerous technique and should not be delegated to an inexperienced operator. In neonates it is unwise to take biopsy specimens more than 4 cm from the anal verge. A posterior approach is likely to be safer than an anterior or lateral one.

Biopsy↗
PubMed1981

Suction tubes for conventional and microscopic neurosurgery.

A set of suction tubes has been designed for both conventional neurosurgery done with the naked eye and microneurosurgery. All of the suction tubes have blunt, rounded tips that allow them to be used for manipulating tissue as well as for suction, and they are designed so that the surgeon's hand can rest comfortably on the wound margin while holding the tube in a pencil-type grip. The set includes the range of diameters needed for microsurgery and macrosurgery and the different lengths needed for superficial and deep intracranial and transsphenoidal operations.

Microsurgery↗
PubMed1996

Alteration of lipoproteins of suction blister fluid by UV radiation.

Suction blister fluid is a good representative of the interstitial fluid feeding the epidermal cells. Lipoproteins contained in the suction blister fluid of healthy volunteers are readily photo-oxidized by UV radiation in the wavelength range 290-385 nm. Absorbed light doses equivalent to one minimal erythemal dose absorbed by skin exposed to UVB (e.g. 290-320 nm) are sufficient to induce lipid peroxidation and modification of apolipoproteins A-I, A-II and B. Albumin, which is known to protect serum fully from oxidative stresses, is not so effective against photo-oxidation. Although tryptophan (Trp) residues of proteins contained in the suction blister fluid are photo-oxidized, apolipoprotein A-II, which does not contain any chromophoric Trp residue, is also altered by the UV radiation. With regard to results obtained with a model reconstituted fluid, it is suggested that the radical chain reaction of the lipid peroxidation can transfer the initial photodamage at sites not directly susceptible to photo-oxidation. The biological implications of these results are discussed.

Apolipoprotein A-I↗
PubMed2005

Suction drain-induced haemorrhage after nerve- and vessel-sparing axillary lymph node dissection for breast cancer.

Suction drainage following axillary lymph node dissection for breast cancer is generally accepted as a routine measure for reducing seroma formation. When performing more nerve- and vessel-sparing axillary lymph node dissection, nerves and vessels can be ruptured by the suction of the drainage system. In the literature no reports could be found describing this type of complication. When using a suction system, we recommend a low-pressure system and that the fully perforated drain should not reach or touch neighbouring vessels or nerves in the axilla when installed.

Breast Neoplasms↗
PubMedDate not supplied

Building evidence for practice: a pilot study of newborn bulb suctioning at birth.

The purpose of the study was to examine the effects of bulb suctioning on healthy, term newborns and the feasibility of conducting a large-scale study of this practice. In a randomized, controlled two-group design pilot study, 10 newborns received oronasopharyngeal bulb suctioning at birth and 10 did not. Differences in Apgar scores, heart rates, and oxygen saturation levels were determined. Infants were randomized to groups before delivery. The participants were 20 term, healthy newborns of uncomplicated pregnancies. Apgar scores, heart rates, and oxygen saturation levels in the first 20 minutes of life were the main outcome variables. There were no statistically significant differences in Apgar scores between groups. Apgar scores at 5 and 10 minutes were 9 or 10 for all newborns. Newborns receiving bulb suctioning showed a statistically significant, lower heart rate (P=.042) during the first 20 minutes and a significantly higher SpO2 level (P=.005) by 15 minutes of age. Although statistically significant, these findings were not considered clinically significant because values remained within normal parameters.

Adolescent↗
PubMed2004

Gastric suction at birth associated with long-term risk for functional intestinal disorders in later life.

OBJECTIVE: To test the hypothesis that noxious stimulation at birth may increase the long-term risk for developing psychosomatic or functional disorders during later life. STUDY DESIGN: Matched case-control study using sibling controls. The birth records were retrieved for the offspring of 494 mothers who, after uncomplicated pregnancies, had delivered two or more children with birth weights at least 2500 g, if at least one child was exposed to a perinatal complication or birth asphyxia. Among their offspring (N=1110), the 108 cases hospitalized for functional intestinal symptoms were identified from nationwide hospital discharge records. Of these, 96 cases were compared with 116 unaffected sibling controls. RESULTS: Functional intestinal symptoms occurred more commonly among the 1110 subjects (9.5%) than in the general population (3.4%, chi(2)=124, P<10(-6)). Gastric suction at birth occurred more frequently among the cases compared with their siblings (22.9% vs 11.2%). There were no differences in the number of cases and controls exposed to perinatal trauma or birth asphyxia. Multivariate logistic regression analyses showed that gastric suction at birth was associated with functional intestinal disorders during later life (odds ratio, 2.99; 95% confidence interval, 1.32-6.79; P=.009), whereas maternal, perinatal, or other confounding variables were not significant. CONCLUSIONS: Noxious stimulation caused by gastric suction at birth may promote the development of long-term visceral hypersensitivity and cognitive hypervigilance, leading to an increased prevalence of functional intestinal disorders in later life.

Adolescent↗
PubMed2003

Expanded use of suction and stabilization devices in cardiothoracic surgery.

BACKGROUND: Recent developments in beating heart instrumentation have allowed surgeons to perform multivessel off-pump coronary artery bypass surgery by overcoming the factors that impair surgical performance (limited visualization, continuous movement of the target area, and hemodynamic instability during exposure of the inferior and posterior parts of the heart). We have explored the possibility of further expanding apical and epicardial suction devices beyond their ordinary use in coronary artery surgery. METHODS: A retrospective review of our cardiac surgery database was undertaken to identify the incidences in which these devices have been used in a somewhat novel manner in the field of cardiac surgery. RESULTS: During this time period we identified 20 instances in which either apical or epicardial suction devices were used alone or together. The nature of the procedures included dividing pericardial adhesions (pericardiectomy, n = 2; dividing adhesions in redo-coronary surgery, n = 4), securing epicardial hemostasis (penetrating cardiac trauma, n = 2; securing hemostasis during reexploration after cardiac surgery, n = 10), and facilitating epicardial microwave ablation (n = 2). On all 20 occasions the intended procedures were undertaken uneventfully. Furthermore, the use of apical and epicardial devices greatly facilitated the operative procedures and avoided the use of cardiopulmonary bypass on all occasions. CONCLUSIONS: In summary, we would like to highlight the expanding role for apical and epicardial suction devices to an area beyond coronary artery surgery in which we have found their use invaluable.

Atrial Fibrillation↗
PubMed1998

Cardiotomy suction: a major source of brain lipid emboli during cardiopulmonary bypass.

BACKGROUND: Brain injury remains a significant problem in patients undergoing cardiac surgery assisted by cardiopulmonary bypass (CPB). Autopsy brain specimens of patients after cardiac operations with CPB reveal numerous acellular lipid deposits (10 to 70 microm) in the microvasculature. We hypothesize that these small capillary and arterial dilatations result from a diffuse inflammatory response to CPB or from emboli delivered by the bypass circuit. This study was undertaken to determine which aspect of CPB is most clearly associated with these dilatations. METHODS: Thirteen dogs were studied in four groups: group I (n = 3), right-heart CPB; group II (n = 2), lower-extremity CPB; group III (n = 3), hypothermic CPB; and group IV (n = 5), hypothermic CPB with cardiotomy suction. All dogs in all groups were maintained on CPB for 60 minutes and then euthanized. Brain specimens were harvested, fixed in ethanol, embedded in celloidin, and stained with the alkaline phosphate histochemical technique so that dilatations could be counted. RESULTS: All dogs completed the protocol. The mean density of dilatations per square centimeter for each group was as follows: group I, 1.77 +/- 0.77; group II, 4.17 +/- 1.65; group III, 4.54 +/- 1.69; and group IV, 46.5 +/- 14.5. In group IV (cardiotomy suction), dilatation density was significantly higher than in group III (hypothermic cardiopulmonary bypass) (p = 0.04) and all other groups (p = 0.04). CONCLUSIONS: Blood aspirated from the surgical field and subsequently reinfused into dogs undergoing CPB produces a greater density of small capillary and arterial dilatations than CPB without cardiotomy suction, presumably because of lipid microembolization.

Alkaline Phosphatase↗
PubMed2000

The effect of cardiotomy suction on the brain injury marker S100beta after cardiopulmonary bypass.

BACKGROUND: An increase of S100beta in serum during cardiopulmonary bypass (CPB) has been interpreted as a sign of brain injury. Cardiotomy suction may cause fat embolization, and its role in the S100beta increase was examined. METHODS: Twenty coronary artery operation patients were randomly assigned to two groups, 10 with suction during CPB to cardiotomy reservoir (CR), 10 to cell saving device (CS). S100beta was measured (immunoassay) in blood from the patients and from cell saving device after processing. In 7 additional patients S100beta was measured in the cell saving device before processing and directly from the wound at sternotomy. RESULTS: Before anesthesia, serum S100beta was 0.03+/-0.06 microg/L. At the end of CPB it was 2.47+/-1.31 microg/L and 0.44+/-0.27 microg/L (CR vs CS; p < 0.001). S100beta was 33+/-12 microg/L in CS reservoir and 42+/-18 microg/L in blood from the wound. CONCLUSIONS: Most serum S100beta after CPB with cardiotomy suction may be of extracerebral origin. S100beta after CPB with cell saving device was the same as after off-pump operation. The interpretation that an increase in S100beta during CPB in patients reflects cerebral injury must be questioned.

Aged↗
PubMed1997

Targeting of dobutamine to ischemic myocardium without systemic effects by selective suction and pressure-regulated retroinfusion.

OBJECTIVE: To study the effects of low-dose dobutamine and/or glyceryl trinitrate in addition to selective suction and pressure-regulated retroinfusion with arterial blood on regional myocardial function of the ischemic myocardium and systemic hemodynamics. METHODS: Using a pig model of repeated brief (90 s) occlusions of the left anterior descending artery, selective suction and pressure-regulated retroinfusion was carried out either with arterial blood alone (SSRalone) or with arterial blood and simultaneous application of low-dose dobutamine (0.1 microgram/kg/min (SSRDOB), glyceryl trinitrate (0.03 mg/kg/min) (SSRNIT) or the combination of both drugs (SSRDOB + NIT). Regional myocardial function of the ischemic and non-ischemic myocardium was determined by sonomicrometry (segment shortening). RESULTS: Segment shortening in the ischemic area after 90 s of ischemia was preserved at 57.5 +/- 9.2% with SSRalone but at 78.0 +/- 22.3% of baseline with SSRDOB (P < 0.05). The addition of glyceryl trinitrate did not improve regional myocardial function further. No effects of locally applied dobutamine were observed with regard to non-ischemic myocardium or heart rate. Cardiac output and mean arterial blood pressures tended to be further stabilized with SSRDOB. CONCLUSIONS: Local application of low-dose dobutamine together with arterial blood by selective suction and pressure-regulated retroinfusion during brief myocardial ischemia resulted in improved regional myocardial function without undesired effects on non-ischemic myocardium or systemic hemodynamics.

Animals↗
PubMedDate not supplied

Changes in esophageal wall layers during motility: measurements with a new miniature ultrasound suction device.

We have developed a miniaturized ultrasound device that attaches to the gastrointestinal mucosa by suction and produces high-resolution (+/- 0.1 mm) images of the layers of the intestinal wall. The esophageal wall layers in a single sheep were measured during 20 occlusive contractions observed with simultaneous endoscopy, which revealed thickening of the inner circular muscle layer from 1.2 +/- 0.2 mm to 2.2 +/- 0.4 mm (p < 0.01), and during 20 dilations demonstrating thinning of the full thickness of the esophageal wall from 3.6 +/- 0.3 mm to 2.9 +/- 0.3 mm (p < 0.01). Safety experiments performed in two canine stomachs demonstrated no erosions or ulceration at any level of suction. Our investigations indicate that the M-mode suction ultrasound device can safely assess changes occurring in the layers of the esophageal wall during contractions and dilations and should be evaluated for the study of human intestinal motility.

Animals↗
PubMed1988

Need for endotracheal intubation and suction in meconium-stained neonates.

In a prospective study, we determined whether routine immediate tracheal aspiration at birth is necessary in meconium-stained but otherwise normal infants delivered vaginally and having a 1-minute Apgar score greater than 8. A total of 572 newborn infants who met these criteria were randomly allocated to one of two groups. All infants underwent oropharyngeal suctioning with a DeLee catheter while the head was still on the perineum. In group I (n = 308) suctioning of the trachea under direct vision was performed instantly at birth; in group II (n = 264) this procedure was not done. There was no mortality among infants in the study, but morbidity, mainly pulmonary and laryngeal disorders, occurred in six of 308 group I infants and in none of the group II infants (P less than 0.025). Immediate tracheal suction is not a harmless intervention, and should be considered superfluous in a vigorous term neonate born with meconium-stained amniotic fluid.

Apgar Score↗