TECHNICAL An alternative
NOTE
method for securing suction drains
D. T. Falconcr Department
of Oral
and Maxillofacial Surgery,
Ysbyty Glan Clwyd, Rhyl, North Wales
Sc/MMA KY. A reliable method of securing suction drain tubing is presented. It ensures that the tubing lies flat on the skin and runs in the direction the surgeon wishes. The method uses an adhesive tape (Elastoplast) ‘flag’ on the tubing.
INTRODUCTION
The use of suction drains is an essential part of surgical practice. Wound breakdown is more common if haematomas are allowed to form in wounds or haematomas and serous collections to occur under flaps. The premature loss of vaccum on a drain caused by the tubing slipping through the skin and the side holes becoming exposed can have the same consequences as not using a drain. Many surgical texts state the need for drains but do not indicate how they should be secured. Rob and Smith (1982) illustrated the commonly employed technique of running repeated loops of suture material around the drain giving the appearance of a Roman garter
Fig. I -The
‘Roman Garter’
(Fig. 1). In our experience this method is prone to loosening with consequent slipping of the drain partly or wholly out of the wound. The tubing tends to exit at right angles to the skin surface allowing easier dislodgement and making it more difficult to lay the tubing comfortably next to the skin. Finally the tubing does not take a fixed path on leaving the skin. The following method of securing the drain goes some way towards overcoming these problems. TECHNIQUE
A piece of 2 cm wide adhesive tape (Elastoplast) of sufficient length to go around the drain tube and allow a 1 cm tail of the sticky sides stuck to each
~iR.2-‘Thc’Elastoplast
Flag’
An alternative
other is applied to the tubing 0.5 cm from its exit through the skin. This provides a flag that will not slip on the tubing. This is sutured to the adjacent skin using a horizontal mattress suture (Fig 2). The drain is thus made to lie flat against the skin and to run in a suitable direction, both factors making it more comfortable for the patient. The Elastoplast can be autoclaved without significant loss of adhesion ensuring that the surgeon’s gloves are not contaminatcd during suturing of the drain.
Acknowledgements I would like to thank Mr J. G. Phillips for his encouragement to present this technical note and the hospital photographic department for its assistance.
method for securing suction drains
Reference Rob,C.&Smith.R.(1982).OperuriveSur~c~r~, Genercrl Principles. Hreasrand Exiru Cranial Endocrim~, 4th Ed.. p 159. London& Boston: Ruttcrworths.
The Author T Falconer FDSKCS, ARCS Registrar DcpartmentofOralandMaxillofacialSurgery. YsbytyGlanClwyd. Bodelwyddan, Rhyl. ClwydLLIXSlJJ. North Wales Paper rcceivcd ISOctol~er 1991 Acccpted5November 1991
131
NOTE
method for securing suction drains
D. T. Falconcr Department
of Oral
and Maxillofacial Surgery,
Ysbyty Glan Clwyd, Rhyl, North Wales
Sc/MMA KY. A reliable method of securing suction drain tubing is presented. It ensures that the tubing lies flat on the skin and runs in the direction the surgeon wishes. The method uses an adhesive tape (Elastoplast) ‘flag’ on the tubing.
INTRODUCTION
The use of suction drains is an essential part of surgical practice. Wound breakdown is more common if haematomas are allowed to form in wounds or haematomas and serous collections to occur under flaps. The premature loss of vaccum on a drain caused by the tubing slipping through the skin and the side holes becoming exposed can have the same consequences as not using a drain. Many surgical texts state the need for drains but do not indicate how they should be secured. Rob and Smith (1982) illustrated the commonly employed technique of running repeated loops of suture material around the drain giving the appearance of a Roman garter
Fig. I -The
‘Roman Garter’
(Fig. 1). In our experience this method is prone to loosening with consequent slipping of the drain partly or wholly out of the wound. The tubing tends to exit at right angles to the skin surface allowing easier dislodgement and making it more difficult to lay the tubing comfortably next to the skin. Finally the tubing does not take a fixed path on leaving the skin. The following method of securing the drain goes some way towards overcoming these problems. TECHNIQUE
A piece of 2 cm wide adhesive tape (Elastoplast) of sufficient length to go around the drain tube and allow a 1 cm tail of the sticky sides stuck to each
~iR.2-‘Thc’Elastoplast
Flag’
An alternative
other is applied to the tubing 0.5 cm from its exit through the skin. This provides a flag that will not slip on the tubing. This is sutured to the adjacent skin using a horizontal mattress suture (Fig 2). The drain is thus made to lie flat against the skin and to run in a suitable direction, both factors making it more comfortable for the patient. The Elastoplast can be autoclaved without significant loss of adhesion ensuring that the surgeon’s gloves are not contaminatcd during suturing of the drain.
Acknowledgements I would like to thank Mr J. G. Phillips for his encouragement to present this technical note and the hospital photographic department for its assistance.
method for securing suction drains
Reference Rob,C.&Smith.R.(1982).OperuriveSur~c~r~, Genercrl Principles. Hreasrand Exiru Cranial Endocrim~, 4th Ed.. p 159. London& Boston: Ruttcrworths.
The Author T Falconer FDSKCS, ARCS Registrar DcpartmentofOralandMaxillofacialSurgery. YsbytyGlanClwyd. Bodelwyddan, Rhyl. ClwydLLIXSlJJ. North Wales Paper rcceivcd ISOctol~er 1991 Acccpted5November 1991
131
