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PubMed2001

[Meconium in the amniotic fluid: prevention of meconium aspiration and elective tracheal suction].

For many years early systematic intubation and tracheal suction have been advocated for meconium-stained infants. Recent data show that they do not reduce the frequency of pulmonary meconium aspiration and underline the importance of a preventive attitude (i.e., intrapartum oropharyngeal suction before shoulder clearing and thoracic compression before first breathing) together with a selective tracheal suction only in the newborns with obvious oropharyngeal meconial staining.

Algorithms↗
PubMed1999

Perforation of the right ventricle by a suction drain.

Suction drains can be used as alternatives to conventional underwater seal drains following cardiac surgery, and may be advantageous under some circumstances. The authors present a case where a suction drain eroded into the right ventricle causing near-fatal haemorrhage following coronary artery surgery. Caution should be exercised in taking the decision to use suction drains, the material from which they are manufactured should be chosen carefully, and close attention paid to their positioning within the mediastinum.

Aged↗
PubMed1976

Neonatal infection due to Salmonella worthington transmitted by a delivery-room suction apparatus.

An outbreak of diarrhoea due to Salmonella worthington in five newborn babies, 5 weeks after a similar outbreak in 13 babies for which no cause had been found, occurred in the nursery of a maternity ward. The source of infection was traced to the contaminated rubber tubing of a mechanical suction apparatus. S. worthington was isolated from the rubber tubing and the Y connexion of the suction apparatus from which all the five infected babies had received suction. Reflux of contaminated amniotic fluid into the sterile catheter connected to the apparatus some time before use could have been the means of introducing the infected material to the oropharynx of the newborn babies, and amniotic fluid, acting as a good medium to support the growth of S. worthington, might be responsible for the long-lasting contamination.

Cross Infection↗
PubMed1983

Results of burr hole and open or closed suction drainage for chronic subdural hematomas in adults.

Chronic subdural hematomas in adults are not technically difficult to treat. They probably constitute one of the most common potentially curable lesions with which the average neurosurgeon deals. Despite this (or perhaps because of it) numerous treatments, radically differing from one another, have been advocated. Fine judgment is called for in deciding whether or not to operate in the first instance, make a flap or one or more burr or twist drill holes, use a drain, employ suction, inflate the brain, leave the bone flap out. In a personal series of 71 chronic subdural hematomas, 46 were treated with a red rubber catheter drain through a burr hole and 23 with a closed system suction drain. The results of this series suggest that closed system suction drainage through a single burr hole is the better of the two techniques. It has important theoretical advantages and the procedure is simple and fast. The complication rate is low and patients have a shortened postoperative hospital stay.

Chronic Disease↗
PubMed1994

Severe penile erosion after use of a vacuum suction device for management of erectile dysfunction in a spinal cord injured patient. Case report.

We report a case of severe erosion and cellulitis at the base of the penis as a result of vacuum suction device constriction bands left on for 4 hours in a spinal cord injured patient with paraplegia and hypesthesia of the genital area. All patients using vacuum suction devices need to be properly educated regarding usage and risks with adequate follow up; patients with hypesthesias and spinal cord injuries need information specifically related to their decreased or absent level of sensation. Only two out of seven vacuum suction device brochures reviewed warn of the risk to patients with decreased sensation in the penis, but none specifically address usage or risks to men with spinal cord injuries.

Adult↗
PubMedDate not supplied

Closed suctioning of intubated neonates maintains better physiologic stability: a randomized trial.

OBJECTIVE: To evaluate the physiological variance in a closed (CS) vs an open suction (OS) protocol in intubated infants. STUDY DESIGN: Infants were stratified into three weight groups in a randomized crossover trial. Heart rate, respiratory rate, blood pressure, oxygen saturation, transcutaneous oxygen and carbon dioxide, and end-tidal carbon dioxide were recorded prior to suctioning, during suctioning, and recovery to baseline. Following the procedures, recovery time to baseline parameters was measured. Data were analyzed using repeated measures ANOVA. RESULTS: Overall, there was significantly less deviation from baseline physiological parameters with CS. Infants <1000 g had clinically significant decreases in heart rate with the OS method (-18% OS vs -6% CS; p=0.016). Recovery time in the OS group was twice that of the CS cohort (4 vs 2 minutes; p<0.001). CONCLUSION: CS maintains better physiologic stability in intubated infants.

Cross-Over Studies↗
PubMed2003

Human subcutaneous tissue distribution of fluconazole: comparison of microdialysis and suction blister techniques.

AIMS: To investigate uptake of fluconazole into the interstitial fluid of human subcutaneous tissue using the microdialysis and suction blister techniques. METHODS: A sterile microdialysis probe (CMA/60) was inserted subcutaneously into the upper arm of five healthy volunteers following an overnight fast. Blisters were induced on the lower arm using gentle suction prior to ingestion of a single oral dose of fluconazole (200 mg). Microdialysate, blister fluid and blood were sampled over 8 h. Fluconazole concentrations were determined in each sample using a validated HPLC assay. In vivo recovery of fluconazole from the microdialysis probe was determined in each subject by perfusing the probe with fluconazole solution at the end of the 8 h sampling period. Individual in vivo recovery was used to calculate fluconazole concentrations in subcutaneous interstitial fluid. A physiologically based pharmacokinetic (PBPK) model was used to predict fluconazole concentrations in human subcutaneous interstitial fluid. RESULTS: There was a lag-time (approximately 0.5 h) between detection of fluconazole in microdialysate compared with plasma in each subject. The in vivo recovery of fluconazole from the microdialysis probe ranged from 57.0 to 67.2%. The subcutaneous interstitial fluid concentrations obtained by microdialysis were very similar to the unbound concentrations of fluconazole in plasma with maximum concentration of 4.29 +/- 1.19 microg ml(-1) in subcutaneous interstitial fluid and 3.58 +/- 0.14 microg ml(-1) in plasma. Subcutaneous interstitial fluid-to-plasma partition coefficient (Kp) of fluconazole was 1.16 +/- 0.22 (95% CI 0.96, 1.35). By contrast, fluconazole concentrations in blister fluid were significantly lower (P < 0.05, paired t-test) than unbound plasma concentrations over the first 3 h and maximum concentrations in blister fluid had not been achieved at the end of the sampling period. There was good agreement between fluconazole concentrations derived from microdialysis sampling and those estimated using a blood flow-limited PBPK model. CONCLUSIONS: Microdialysis and suction blister techniques did not yield comparable results. It appears that microdialysis is a more appropriate technique for studying the rate of uptake of fluconazole into subcutaneous tissue. PBPK model simulation suggested that the distribution of fluconazole into subcutaneous interstitial fluid is dependent on tissue blood flow.

Adult↗
PubMedDate not supplied

Closed suction drainage versus no drainage following pelvic lymphadenectomy for gynecological malignancies.

The present study was undertaken in the Department of Gynecologic Oncology, Kidwai Memorial Institute of Oncology, Bangalore between October 1998 and July 1999. One hundred and forty three consecutive patients with various gynecological malignancies undergoing pelvic +/- aorto-caval lymphadenectomy as part of definitive surgical procedures, were analyzed. Sixty nine patients had closed suction retroperitoneal pelvic drainage (Group A) and 74 patients had no suction drainage and no pelvic reperitonealization (Group B). The mean postoperative hospitalization was 10 days in both groups. Six patients in Group A and four patients in Group B developed paralytic ileus which responded to conservative line of management. Five patients in Group A and two patients in Group B developed lymphocysts (P > 0.05). The present study demonstrates that closed suction retroperitoneal pelvic drainage following pelvic + aorto-caval lymphadenectomy confers no advantage over no drainage & no pelvic reperitonealization. The partial closure of pelvic peritoneum with no drainage was associated with increased lymphocyst formation (7/25 cases, 28%) during the period immediately before this modified study was undertaken.

Adolescent↗
PubMed2002

Laparoscopy-assisted suction colonic biopsy and intraoperative rapid acetylcholinesterase staining during transanal pull-through for Hirschsprung's disease.

BACKGROUND: It is crucial to identify the exact level of transition to normal ganglion cells in instances of Hirschprung's disease. This report describes a technique for laparoscopy-assisted suction colonic biopsy during transanal pull-through. METHODS: Laparoscopy-assisted suction colonic biopsy (SCBx) was used in 12 patients with Hirschsprung's disease affecting the rectosigmoid. Average age was 4.4 +/- 2.1 months with a mean operative weight 6.2 +/- 1.0 kg. The pull-through was performed as the primary operative procedure in 11 patients. Using a 2-team approach (laparoscopic team and transanal team), the site was chosen for transanal suction biopsy and marked externally by the laparoscopic team with a silver clip. Biopsies were processed for ganglion cells and rapid AChE technique. RESULTS: There were no biopsy-induced perforations. Abnormal biopsies were repeated more proximally until ganglion cells were observed. Transanal pull-through was performed and an open full-thickness biopsy performed to confirm the presence of ganglion cells. All procedures were performed successfully. CONCLUSIONS: Laparoscopy-assisted SCBx can be used successfully in patients with Hirschsprung's disease affecting the rectosigmoid (80% of cases). The technique, when used with rapid AChE staining, provides accurate identification of the level of normoganglionosis.

Acetylcholinesterase↗
PubMed2005

[Examination of a new tube connector concerning the ventilation-leakage during intraoperative bronchoskopy and bronchal suction].

BACKGROUND AND OBJECTIVE: Intra-operative bronchial suction and bronchoscopy regularly diminishes ventilation pressures and volumes and causes a leakage of narcotic gases. This study was undertaken to compare the influence of a newly-developed connecting tube with check valve on these problems. METHODS: Examinations were carried out in a pressure controlled test lung with ventilation pressures between 5 and 50 mbar. Usual tube connectors and newly developed connectors with check valve were examined with respect to ventilation pressures, ventilation volumes, and leakage before and after insertion of suction catheters and bronchoscopes. RESULTS: Using normal connectors, ventilation pressures and volumes collapsed even at lowest expiratory pressures, and significant leakage occurred. The insertion of catheters or bronchoscopes had only little beneficial effects. In contrast, the new connectors with check valve showed only small leakage, even at high ventilation pressures. CONCLUSION: The new tube connectors with check valve allow intra-operative suction and bronchoscopy under constant ventilation parameters with minor leakage of anaesthetic gas.

Anesthetics, Inhalation↗
PubMed1996

A new suction device for microsurgery.

A new suction device for microsurgical procedures is presented. This device is made of soft, compliant PVC, which enables all fluids to be evacuated from the surgical field without damaging the surrounding soft tissue. The device is designed with front and radial ports that allow placement onto the blood vessel or nerve while the anastomosis is being performed. There is a tapered end providing the surgeon with fine control of the suction. Unlike other bulky suction devices, this one readily fits into the operative field without inhibiting operative procedures. It also readily fits varying sizes of conventional Frazier-type tips. The device has been used in over 100 microsurgical procedures and it has served well.

Humans↗
PubMed1993

[Reconstruction of a malformed external ear by an endoprosthesis of porous polyethylene with an integrated suction system].

Complete reconstruction of the external ear is one of the most difficult tasks in plastic and reconstructive surgery. The risk of frame protrusion inherent in all alloplastic materials is reduced by using a new premoulded endoprosthesis with an integrated suction system. It consists of tissue-compatible porous polyethylene. A conventional suction drainage can be attached to a hollow canal system within the endoprosthesis that empties from defined spaces corresponding to the natural concavities of the external ear. In combination with a preceding expansion the overlying skin is then adapted evenly and completely to the frame by suction. As a result of this vacuum seromas and haematomas can be prevented. Furthermore, infections and pressure necroses due to matress sutures cannot develop. The use of this endoprosthesis obviates the removal of autogenous cartilage and all the complications and scars that are connected with this procedure. The frame itself is stable and has a relief that is largely similar to the natural form of the auricle. Thus, an aesthetically satisfying result can be achieved also in the hand of the surgeon who is not often engaged in this field of plastic surgery.

Adolescent↗
PubMed1998

Continuous suction surgical cottonoid for microneurosurgery.

A new suction device for microneurosurgery is presented. A surgical cottonoid is covered with a polyethylene film so that vacuum power is maintained throughout the length of the cottonoid. One end is connected to a vacuum pump via a plastic tube. Five to 10 mm of the surgical cottonoid are exposed for suctioning at the other end of the cottonoid. The suction surgical cottonoid is flexible and safe, avoiding tissue damage. In addition, the surgeon can manipulate the exposed cottonoid at the tip as any other surgical cottonoid.

Equipment Design↗
PubMed2001

The value of suction drainage fluid culture during aseptic and septic orthopedic surgery: a prospective study of 901 patients.

There are no guidelines on the value of suction drainage fluid culture (SDC), and it is difficult to determine whether the organisms cultured from suction drainage fluid samples are pathogenic or simply contaminants. We performed 2989 cultures of suction drainage fluid samples obtained, during a 1-year period, from 901 patients who underwent aseptic or septic orthopedic surgery (946 operations). The culture results were analyzed to evaluate their ability to detect postoperative infection after aseptic operations or to detect either a persistent or new episode of sepsis in patients known to have infection. For aseptic operations, the sensitivity of SDC was 25%, the specificity was 99%, the positive predictive value was 25%, and the negative predictive value was 99%. For septic operations, the sensitivity of SDC was 81%, the specificity was 96%, the positive predictive value was 87%, and the negative predictive value was 94%. We conclude that, for aseptic orthopedic surgery, SDC is not useful in detecting postoperative infection. However, for septic orthopedic surgery, it is of clinical importance.

Adolescent↗
PubMed2004

Holmium laser percutaneous nephrolithotomy using a unique suction device.

BACKGROUND AND PURPOSE: Most percutaneous nephrolithotomies are performed with electrohydraulic, ballistic, or ultrasonic lithotripsy, with holmium laser use reserved for ureteroscopy or ureterorenoscopy. We evaluated the feasibility of holmium laser use in percutaneous nephrolithotomy with the assistance of a unique suction device. PATIENTS AND METHODS: The charts of 71 consecutive patients undergoing 90 percutaneous procedures were reviewed. A unique suction device and the holmium laser were used in nearly half the patients. The average stone burden was 3.25 cm. Use of holmium laser, energy settings, stone burden, operative time, complications, and stone-free rate were evaluated. RESULTS: The average operative time was 167 minutes with a complication rate of 14%. A stone-free rate of 83% was achieved with the laser. CONCLUSIONS: With the assistance of a unique suction device, the holmium laser can, in the appropriate situation, be an efficient and successful lithotrite with percutaneous nephrolithotomy.

Humans↗
PubMed1994

Tracheal suction in meconium stained infants: a randomized controlled study.

We performed a randomized controlled study of the mortality and morbidity of 49 babies born with thick meconium staining of amniotic fluid. These unasphyxiated babies were consecutively born and were admitted to the intensive care unit for observation as routine. The groups were comparable in regard to sex, birth weight, gestational age, maternal factors like anaemia, toxaemia, antepartum haemorrhage, prolonged rupture of membranes, presentation, and interventions including caesarian section. The control group, comprising 26 babies received only oropharyngeal suction, while the intervention group, comprising 23 babies, underwent oropharyngeal suction followed by tracheal suction. There was no significant difference in the mortality or morbidity in form of evidence of air leak or hypoxic ischaemic encephalopathy.

Female↗
PubMed2002

Sinusoidal neck suction for evaluation of baroreflex sensitivity during desflurane and sevoflurane anesthesia.

UNLABELLED: Sevoflurane and desflurane modulate autonomic nervous activity by different mechanisms. We tested the hypothesis that these anesthetics also exhibit different effects on short-term baroreflex regulation of arterial blood pressure. Forty ASA physical status I patients, aged 20 to 42 yr, were randomly assigned to receive either 1.0 minimum alveolar anesthetic concentration of sevoflurane or desflurane for the maintenance of anesthesia. Patients were studied during awake conditions and 20 min after the anesthesia induction using sinusoidal neck suction at 0.2 Hz (baroreflex response mediated mainly by vagal activity) and 0.1 Hz (baroreflex response mediated by vagal and sympathetic activity), whereas respiratory frequency was fixed at 0.25 Hz. RR interval and arterial blood pressure responses were evaluated by power spectral analysis and complex transfer function analysis. Sevoflurane and desflurane did not disturb the linear relationship between baroreceptor stimulation and effector response, expressed as squared coherence of signals, i.e., the equivalent of the correlation coefficient of power spectra. Sevoflurane and desflurane depressed the response of the heart rate to neck suction in a similar way without affecting the time delay between baroreceptor stimulation and vagal-mediated cardiac response. The gain of the transfer function between neck suction and oscillation in arterial blood pressure at 0.1 Hz decreased with sevoflurane and desflurane to comparable values. Both anesthetics increased the delay of systolic blood pressure response to baroreceptor stimulation from approximately 3.5 to 4.3 s. Baroreflex-mediated short-term control of arterial blood pressure is similar between desflurane and sevoflurane during steady-state conditions. IMPLICATIONS: Despite exhibiting different effects on autonomic activity, sevoflurane and desflurane depress the baroreflex-mediated short-term control of heart rate and blood pressure in a similar manner.

Adult↗
PubMed1988

Hypersensitivity dermatitis following suction-assisted lipectomy: a complication of local anesthetic.

We report a case of severe dermatitis involving the abdomen and thighs following suction-assisted lipectomy of these areas wherein local anesthetic containing the preservative methylparaben was used for infiltrative anesthesia. This use of local anesthetics with epinephrine can be of value in the performance of suction-assisted lipectomy to reduce blood loss, serve as an adjunct to other intraoperative anesthetic techniques, and for postoperative analgesia. Local anesthetic solutions commonly contain additives, which serve as antioxidants and antimicrobials. The most common of these preservatives is methylparaben, which can cause delayed hypersensitivity reactions. These reactions may be neither recognized nor clinically significant in small areas of infection, whereas in large body surface infiltrative procedures, such as suction-assisted lipectomy, these reactions may be of considerable consequence. This article reviews the pathophysiology and treatment of these reactions and gives recommendations for avoiding them.

Adipose Tissue↗