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PubMed1994

[The prevention of hypoxemia during endotracheal suctioning].

This work shows a literature review on the methods of prevention of postsuctioning hypoxemia in critically ill patients under artificial ventilation. Such methods have been proposed and published in the last twenty years. After being organized, these data made it possible to identify the most common methods to prevent postsuctioning hypoxemia. These methods are hyperoxygenation, hyperinflation, hyperoxygenation with hyperinflation and the closed method of tracheal suctioning, which allows for a suction without the interruption of the patient's artificial ventilation. A critical analysis of these methods and techniques, emphasizing the conflicting and concordant aspects presented by the several authors studied, made it possible to identify the superiority of the hyperoxygenation with hyperinflation method through the ventilator and the closed method of tracheal suctioning in the prevention of hypoxemia.

Humans↗

PubMed2004

Closed suction drainage for hip and knee arthroplasty. A meta-analysis.

BACKGROUND: The use of closed-suction drainage systems after total joint replacement is a common practice. The theoretical advantages for the use of drains is a reduction in the occurrence of wound hematomas and infection. The aim of this meta-analysis was to determine, on the basis of the evidence from randomized controlled trials, the advantages and adverse effects of surgical drains. METHODS: All randomized trials, as far as we know, that compared patients managed with closed-suction drainage systems and those managed without a drain following elective hip and knee arthroplasty were considered. The trials were identified with use of searches of the Cochrane Collaboration with no restriction on languages or source. Two authors independently extracted the data, and the methods of all identified trials were assessed. RESULTS: Eighteen studies involving 3495 patients with 3689 wounds were included in the analysis. The pooled results indicated that there was no significant difference between the wounds treated with a drain and those treated without a drain with respect to the occurrence of wound infection (relative risk, 0.73; 95% confidence interval, 0.47 to 1.14), wound hematoma (relative risk, 1.73; 95% confidence interval, 0.74 to 4.07), or reoperations for wound complications (relative risk, 0.52; 95% confidence interval, 0.13 to 1.99). A drained wound was associated with a significantly greater need for transfusion (relative risk, 1.43; 95% confidence interval, 1.19 to 1.72). Reinforcement of wound dressings was required more frequently in the group managed without drains. No difference between the groups was seen with respect to limb-swelling, venous thrombosis, or hospital stay. CONCLUSIONS: Studies to date have indicated that closed suction drainage increases the transfusion requirements after elective hip and knee arthroplasty and has no major benefits. Further randomized trials with use of larger numbers of patients with full reporting of outcomes are indicated before the absence of any benefit, particularly for the outcome of wound infection, can be proved.

Aged↗

PubMed2003

Survey of the use of suction drains in head and neck surgery and analysis of their biomechanical properties.

BACKGROUND: Closed suction drains have an important role in surgical wound healing. Although most surgeons use them routinely, indications for use and their postoperative management (emptying, removal) vary. The purpose of this study was to assess drain use by head and neck surgeons in Canada, to conduct a biomechanical analysis of the drains in a laboratory setting, and to make recommendations for drain use and management. METHODS: A survey was mailed to 343 active members of the Canadian Society of Otolaryngology. Three sets of experimental trials were conducted on the most commonly used drains to assess the effect of increased reservoir filling on suction generated through (1) incrementally increasing the amount of fluid within the reservoir, (2) compression of the reservoir with no fluid within, and (3) compression with the reservoirs while filled to 25% capacity with fluid. RESULTS: A 41% response rate was obtained. It was found that the majority of head and neck surgeons in Canada use Hemovac and Jackson-Pratt drainage systems routinely. There is considerable variability in practice with regard to drain emptying and timing of removal. Experimental results indicate that as filling of the reservoir increases, suction generated decreases sharply, to between 13 and 20% of initial values at 50% capacity. CONCLUSION: Postoperative drain management has important implications in surgical wound healing. Drain reservoirs should be monitored frequently to ensure adequate compression, particularly in the first 24 hours after insertion. Anticipated volume of drainage should dictate in part which reservoir is chosen. A larger reservoir is preferable in most cases. Drains should be removed promptly to decrease the risk of wound contamination.

Biomechanical Phenomena↗

PubMed1983

Use of instillation-suction technique in treatment of chronic osteomyelitis.

Willenegger's closed instillation-suction technique for the treatment of chronic bone infection is described in which infected bone is first exposed and all sequestra removed. Two drainage tubes are perforated, inserted and brought out through the skin between 3 and 4 cm from the wound. The perforated portions of the tubes are laid close to the infected area and the wound closed in layers. One tube is connected to a drip bottle containing antibiotic solution and the second to a continuous suction pump. Closed continuous steady flow instillation-suction is thus established. The results of 28 cases are presented out of which 26 cases showed clinical resolution of the infection.

Anti-Bacterial Agents↗

PubMed1985

A self-retaining multipore suction tube. Technical note.

A new self-retaining multipore suction tube with three unusual features is described. The features are: 1) multiple 0.5 mm suction openings; 2) a variable suction control; and 3) a device for fixation to a self-retaining retractor.

Humans↗

PubMed1992

Acetylcholinesterase histochemistry of rectal suction biopsies in the diagnosis of Hirschsprung's disease.

Rectal suction biopsy with acetylcholinesterase (AChE) histochemistry has gained increased acceptance as the means of definitely diagnosing Hirschsprung's disease (HD) as well as of excluding this diagnosis when evaluating children with low intestinal obstruction or chronic constipation since the report of Meier-Ruge et al. in 1972. But this AChE histochemical study has not been reported yet in Korea. During the 14-month period from April, 1991 through June, 1992, 37 children, aged 3 days to 17 years had rectal suction biopsies for the diagnosis or exclusion of HD. In this study, AChE histochemistry (N = 37) was compared with hematoxylin & eosin (H&E) staining of same suction biopsy specimens (N = 35) for diagnostic accuracy. The histochemical criterion used for the diagnosis of Hirschsprung's disease was that of Chow et al. (1977), i.e., the presence of many coarse discrete cholinergic fibers in the muscularis mucosae and in the immediately subjacent submucosa regardless of an infiltration of cholinergic fibers in the lamina propria. Of 13 biopsies from the patients with Hirschsprung's disease (N = 13), there were 12 positive reactions, and one false negative reaction in a neonate with total colonic aganglionosis. All biopsies from 24 unaffected children demonstrated negative reactions with no false positive reaction. In comparison, of the 35 specimens examined by H&E staining, ganglion cells were present in the submucosal Meissner's plexus only in 15 of these 24 unaffected children. In conclusion, a 97% diagnostic accuracy was achieved with AChE histochemistry compared with a 74% accuracy with H&E staining (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Acetylcholinesterase↗

PubMed1990

Comparison between intermittent (spring-loaded) and continuous closed suction drainage of orthopedic wounds: a controlled clinical trial.

A randomized prospective trial of a continuous vacuum system (VariDyne) and an intermittent spring type system (Hemovac) was conducted in 126 consecutive orthopedic surgical wounds between February 1988 and October 1988 in which postoperative suction drainage was required. Comparison between the two groups showed a statistically significant difference among total drainage removed by the vacuum units and wound drainage into the dressing following drain removal. Hip and knee arthroplasty patients receiving continuous vacuum suction experienced a greater average drainage volume and better wound healing than those receiving the spring-loaded device. Overall, all wounds which utilized continuous vacuum drained less serosanguinous or serous fluid than those wounds utilizing the intermittent system following drain removal. A clear advantage to using a continuous vacuum suction device over an intermittent spring-loaded device is seen with respect to hematoma evacuation, wound drainage, wound healing, and possible complications.

Adult↗

PubMed1996

A new scleral suction trephine for retrieval of corneoscleral donor tissue.

BACKGROUND: Removal of donor corneo-scleral shell from a cadaver, leaving the remainder of the eye in place, has become a popular technique. Manual removal can result in excessive trauma to the corneal endothelium or an uneven scleral rim. METHODS: We describe a new technique for corneal retrieval using a sceral suction trephine. RESULTS: The scleral suction trephine was cut evenly in our eyebank study. There was no additional trauma to the endothelium and the scleral rim was regular. CONCLUSION: Suction trephination of the sclera in retrieval of corneal donor tissue appears to be safe and effective.

Aged↗

PubMedDate not supplied

The suction bridge for radial keratotomy may avoid late hyperopic shift.

BACKGROUND: Radial keratotomy may induce late hyperopic shift. We present data on 140 consecutive eyes with a follow-up of up to 3 years that underwent radial keratotomy with the RK suction bridge. METHODS: We conducted a retrospective study of 140 consecutive eyes that had radial keratotomy between 1987 and 1994. Mean preoperative spherical equivalent was -5.21 D (range -2.00 to -9.75 D). All operations were performed by one surgeon (JHK) with the RK suction bridge. A suction ring maintaining physiological intraocular pressure immobilized the eye and left a peripheral rim of uncut cornea. The ring incorporated an eccentric bridge that guided the radial keratotomy knife. The knife setting was 90% of the central corneal thickness, measured by pachymetry. Spherical equivalent refraction and spectacle corrected visual acuity were measured at 1 week, 1, 3, 6 months, 1 year, and 3 years after radial keratotomy. RESULTS: The mean preoperative spherical equivalent refraction of -5.21 D dropped to -0.43 D at 1 week (n = 136), -0.71D at 1 month (n = 120), -0.85 D at 3 months (n = 95), -0.74 D at 6 months (n = 73), -0.77 D at 12 months (n = 79), and -0.85 D at 3 years (n = 67). Compared to 1 month spherical equivalent, at 3 years three eyes (4.4%) had moved > = or 1.00 D toward hyperopia. One eye (1.4%) shifted by 1.25 D. Paired t-tests of mean spherical equivalent refraction did not reveal significant shifts toward hyperopia. Mean preoperative spectacle-corrected visual acuity was slightly diminished at 1 week and was equal or better thereafter. CONCLUSIONS: Our 3-year data suggest that a late hyperopic shift following radial keratotomy may be prevented if an intact peripheral rim is maintained and cutting depth does not exceed 90% of the lowest corneal thickness.

Adolescent↗

PubMedDate not supplied

Reliable site for suction blister induction and harvesting.

BACKGROUND: Suction blister grafting is a useful modality of treatment of patients with resistant and stable vitiligo. However, there have been no detailed studies to find out the best donor site for blister formation. METHODS: The study was conducted between the period of October 2004 and February 2005 in the dermatology department at a tertiary care center. Nine patients with vitiligo (focal vitiligo, 3; mucosal vitiligo, 2; acrofacial vitiligo, 2; vitiligo vulgaris, 1; and segmental vitiligo, 1) were selected for blister harvesting and grafting. The blisters were raised using the method described by Gupta et al. RESULTS: Suction blisters were attempted to be raised at 52 sites, but only 38 blisters could be raised, 24 complete and 14 incomplete. Blisters were raised in all the three cases on the flexor aspect of the arm (100%), 15 of 17 cases (88.2%) on the flexor aspect of the forearm, 4 of 5 cases (80%) on the abdomen, 11 of 16 cases (68.7%) on the anterolateral thigh, and less frequently over leg or foot. Complete blisters were formed in 13/15 cases (86.6%) on the flexor aspect of the forearm, 6/11 cases (54.5%) on the anterolateral thigh, and in all cases over leg. CONCLUSION: The flexor aspect of the forearm is a good site for suction blister harvesting.

Adolescent↗

PubMed1999

A study of the effect of suction drainage on microvascular anastomosis.

The effect of suction drainage on the patency of microvascular anastomosis was evaluated in 20 rats. No anastomosed vessels were sucked into the suction drain. Histologic examination of the specimens showed normal healing of the endothelium across the anastomotic site and no evidence of thrombus formation. The results indicate that the suction pressure does not affect the patency of microvascular anastomosis.

Anastomosis, Surgical↗

PubMed1992

Evaluation of a closed-system, directional-tip suction catheter.

INTRODUCTION: It is difficult to successfully suction the left bronchial tree. We evaluated the success rate of left bronchial cannulation with a new closed-suction directional-tip catheter (Trach Care directional-tip catheter, TCDT, Ballard Medical Products, Midvale UT). Success rates were compared in patients with endotracheal and tracheostomy tubes. We also studied the effects on success rate of (1) the distance of the endotracheal tube from the carina, (2) the tube's bevel orientation, and (3) the tube's position in the patient's mouth. METHOD: At the time of the routine daily chest radiograph, 75 attempts at left bronchial cannulation were made in 45 patients. With the head maintained in a midline position, the TCDT catheter was advanced with the radiopaque blue line in the 1 o'clock position. The radiograph was evaluated for correct placement of the TCDT catheter. RESULTS: Due to lung pathology and x-ray technique, catheter placement could not be interpreted in 17% of the radiographs. In the remainder, overall success rate was 71% (79% with tracheostomy tubes and 67% with endotracheal tubes, not significantly different, with p > 0.3). Tube distance from the carina and bevel orientation did not significantly affect success rates. Success rates for tubes located in the left and central positions of the patient's mouth were significantly better (p < 0.002 and p < 0.03, respectively) than for tubes located on the right side of the patient's mouth. With the endotracheal tube on the left side of the patient's mouth, the success rate was 89%. CONCLUSION: We conclude that the TCDT catheter successfully combines the features of a closed-suction system with those of a directional-tip catheter that allows selective bronchial cannulation, a large percentage of the time.

Bronchi↗

PubMed2000

Early surgical suction and washout for treatment of cytotoxic drug extravasations.

This case report is presented to assess safety and efficiency of early suction and saline washout of extravasated cytotoxic drugs. Through multiple small skin incisions, the area of extravasation is first suctioned and subsequently extensively washed out with saline. Incisions are left open and the arm is elevated for 24 hours. A complete healing was obtained in five days without any skin or soft tissue loss. No additional treatment was needed. Early referral and surgical treatment by suction and washout is a safe and reliable treatment protocol for major cytotoxic drug extravasation injuries.

Adult↗

PubMed2000

Suction methods for assessing contamination on surfaces.

Suction sampling techniques are widely used to assess particulate contamination levels on domestic and occupational surfaces such as floor coverings, but their use for dermal exposure assessment has, to date, been limited. This paper reviews the sampling techniques commonly employed and summarises the range of sampling efficiencies reported in the literature. As there are an extremely large number of key factors influencing the recovery efficiency of suction sampling devices, it is recommended that controlled experiments are carried out to evaluate the relative significance of these factors, thus allowing inter-comparison of the data generated in field studies. As the range of applications of suction sampling devices is extensive, the harmonisation of sampling protocols is not considered to be a feasible objective.

Clinical Protocols↗

PubMed2001

Tonsillectomy. A comparative study of dissection/snare vs suction-cautery.

In an optimal situation, a surgical procedure would be one that generates minimal post-operative pain, incurs little or no bleeding, and allows the patient to return to their normal daily activities in the shortest time period. A tonsillectomy is one of the most common operations performed in the world. Various surgical procedures for tonsillectomy are performed with a wide array of opinions to support the pros and cons of each technique. OBJECTIVES/GOALS: To determine if there is a significant difference between two methods of tonsillectomy. METHODS AND MATERIALS: A prospective single blinded randomized control study using (i) A dissection/snare technique, and (ii) A suction-cautery method. Measured outcomes such as blood loss, surgical time, post-op pain, post-op hydration, pyrexia, and the length of time to resume normal daily activities will be assessed. RESULTS: In total, 50 patients were studied, 23 in the dissection/snare technique, and 27 in the suction cautery technique. Inclusion criteria was, the patient must be at least 2 years of age and not older than 16 years of age. Data was collected intra-operatively, at 2 and 4 hour post-op intervals, as well as a 2 week follow-up questionnaire completed by the parents. CONCLUSIONS: The suction cautery group had statistically significant differences in blood loss, surgical time and pain in the immediate post-operative period.

Adolescent↗

PubMed2002

Reducing dust using the electrocautery pencil with suction combined with the infusion catheter in mastectomy.

The dust from the vaporized tissue released during a mastectomy presents a hazard to the patients and the operating room personnel. More dust has been noted using the conventional electrocautery pencil in dissecting breast tissue than with the metal knife used in the past. It is very important to reduce the hazardous dust released during mastectomy. For this study 80 patients undergoing mastectomy for breast cancer from March to June 2001 were divided into two groups: 1) those whose dissections were performed with a combination of an electrocautery pencil and suction with an intravenous infusion catheter (40 cases) and 2) those whose dissections were performed with the conventional method in which the electrocautery pencil was handled by the surgeon and the metal suction tube was used separately by an assistant (40 cases). During mastectomy the personal air sampler was affixed to the operator's neck to collect the dust from the vaporized tissue. The concentrations of the total dust were significantly lower in the combined electrocautery-suction method (mean 5.56 +/- 3.26 microg/m3) than in the conventional method (mean 34.81 +/- 4.83 microg/m3) during mastectomy (P < 0.05). Although the operating time and blood loss were less in the combined method than in the conventional method this difference was not statistically significant (P > 0.05). The combined method of using the electrocautery pencil for dissecting breast tissue along with the intravenous infusion catheter reduced the concentrations of the total dust from the vaporized tissue plume. Furthermore this method reduces the hazards of dust to the surgeons and operating room personnel. Additionally the cost of this combined method is lower than that of the conventional method.

Adult↗

PubMed2003

[Effect of negative pressure suction on rabbit optic nerve and retina].

OBJECTIVE: To study the effect of acute intraocular pressure (IOP) elevation on the optic nerve and retina in laser in situ keratomileusis (LASIK). METHODS: Acute IOP was increased to 65 mm Hg for different period of time (30 s, 1 min and 3 min) by using scleral suction on rabbit eyes. The tissues of retina and optic nerve of immediately extirpated group (instant group), of 2 weeks later extirpated group (recovery group) both after the negative pressure suction and of normal rabbit eyes were examined with electron and light microscope. RESULTS: After the negative pressure suction for 30 s, 1 min, and 3 min respectively, the optic nerve and retinal cells changed lightly; some part of optic nerve and retinal cells changed; optic nerve fibers and retinal cells changed sharply. CONCLUSION: Ultrastructural changes of retina and optic nerve may be induced by acute IOP elevation in LASIK. The longer the time, the more apparent the changes.

Animals↗

PubMed1992

A retrospective review of tracheal suction at birth in neonates with meconium aspiration syndrome.

A retrospective study of 54 neonates with Meconium Aspiration Syndrome (MAS) admitted to the Paediatric ICU Penang General Hospital from January 1989-December 1990 was carried out to determine if suction of the trachea at birth was performed in this group of patients. 63% were inborn and 27% outborn. The mean birth weight was 3.2 kg, 83% were ventilated, mean duration of ventilation was five days and the mortality was 24%. 63% had an Apgar Score of less than 5 at 1 min and 65% had thick meconium-stained liquor. Only 48% were intubated and suctioned at birth. Overall tracheal suction rate was low.

Humans↗