scholarly journals Tissue sealant versus surgical drain following parotidectomy

The Surgeon ◽  
2021 ◽  
Author(s):  
Nicholas A. O'Keeffe ◽  
Catherine Brophy ◽  
Patrick Sheahan
2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
B Hughes ◽  
J Stallard ◽  
S Jivan

Abstract Introduction Surgical drains are used by many specialities, we aim to determine the most robust method of securing them by comparing suturing technique, material and fixation angle. Method A Blake’s drain was inserted into a piece of pork belly and secured using a standard ‘three half hitch’ technique with 3.0 Silk, EthilonTM and ProleneTM . For each suture type, drains were sutured in line, at 45 and 90 degrees to the course of the drain. The force needed for the suture to failure was measured and each repeated 3 times. Different suture techniques were then used to determine the strongest fixation. Results With the drain exiting inline the moment of failure was, on average, 1.25kg for silk, 3.5kg for EthilonTM and 4.0kg for ProleneTM. Increasing drain fixation angle required more force for the suture to fail. With EthilonTM and ProleneTM, the suture snapped before the drain slipped. Three half hitches was the strongest technique. Conclusions Suture material, technique and drain fixation angle had an impact on suture strength with ProleneTM outperforming Silk. We advocate using a ‘three half hitch’ technique with 3.0 ProleneTM to secure a surgical drain. It offers superior strength whilst reducing the risk of localised tissue reactions.


2021 ◽  
Vol 10 (12) ◽  
pp. 2716
Author(s):  
So-Jeong Yoon ◽  
So-Kyung Yoon ◽  
Ji-Hye Jung ◽  
In-Woong Han ◽  
Dong-Wook Choi ◽  
...  

The latest guidelines from the Enhanced Recovery After Surgery (ERAS®) Society stated that early drain removal after pancreatoduodenectomy (PD) is beneficial in decreasing complications including postoperative pancreatic fistulas (POPFs). This study aimed to ascertain the actual benefits of early drain removal after PD. The data of 450 patients who underwent PD between 2018 and 2020 were retrospectively reviewed. The surgical outcomes were compared between patients whose drains were removed within 3 postoperative days (early removal group) and after 5 days (late removal group). Logistic regression analysis was performed to identify the risk factors for clinically relevant POPFs (CR-POPFs). Among the patients with drain fluid amylase < 5000 IU on the first postoperative day, the early removal group had fewer complications and shorter hospital stays than the late removal group (30.9% vs. 54.5%, p < 0.001; 9.8 vs. 12.5 days, p = 0.030, respectively). The incidences of specific complications including CR-POPFs were comparable between the two groups. Risk factor analysis showed that early drain removal did not increase CR-POPFs (p = 0.163). Although early drain removal has not been identified as apparently beneficial, this study showed that it may contribute to an early return to normal life without increasing complications.


2017 ◽  
Vol 28 (5) ◽  
pp. 1164-1166 ◽  
Author(s):  
Robin Wu ◽  
Alexander Wilson ◽  
Roberto Travieso ◽  
Derek M. Steinbacher

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Michael J. Jarrett ◽  
Andres Vázquez-Torres ◽  
Daniel N. Frank ◽  
Bruce D. McCollister ◽  
Patrick K. Henthorn ◽  
...  

Objective. Gelatin-thrombin matrix (GTM) tissue sealant use was previously identified as an independent predictor of pelvic infection following hysterectomies. We aim to elucidate contributing factors by assessing influence of GTM on bacterial colony formation and characterizing bacteria present at the vaginal cuff.Methods.Escherichia coliwas incubated in phosphate-buffered saline (PBS) and pelvic washings with and without GTM to assess influence on colony formation. Pelvic washings of the vaginal cuff were collected from hysterectomies occurring from June through October 2015.In vitrotechniques, 16S rRNA gene qPCR, and 16S amplicon sequencing were performed with washings to characterize bacteria at the vaginal cuff.Results. Mean bacterial colony formation in PBS was greater forE. coliincubated in the presence of GTM (1.48 × 107 CFU/mL) versus without (9.95 × 105 CFU/mL) following 20-hour incubation (p=0.001). Out of 61 pelvic washings samples, 3 were culture positive (≥5000 CFU/mL) withEnterococcus faecalis.Conclusion.In vitroexperiments support a facilitating role of GTM on colony formation ofE. coliin PBS. However, given the negative results of surgical site washings following adequate disinfection, the role of GTM in promoting posthysterectomy pelvic infections may be limited. Analysis of pelvic washings revealed presence ofE. faecalis, but results were inconclusive. Further studies are recommended.


2009 ◽  
Vol 3 (1) ◽  
Author(s):  
Umberto Morelli ◽  
Roberto Cirocchi ◽  
Valerio Mecarelli ◽  
Eriberto Farinella ◽  
Francesco La Mura ◽  
...  

2005 ◽  
Vol 19 (9) ◽  
pp. 1122-1126 ◽  
Author(s):  
Jonathan E. Bernie ◽  
James Ng ◽  
Vladislav Bargman ◽  
Thomas Gardner ◽  
Liang Cheng ◽  
...  

2011 ◽  
Vol 91 (6) ◽  
pp. e94 ◽  
Author(s):  
Giuseppe Iaci ◽  
Alessandro Castiglioni ◽  
Andrea Fumero ◽  
Mauro Carlino ◽  
Alberto Margonato ◽  
...  

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hui Li ◽  
Yan Du ◽  
Jia-bin Wu ◽  
Pan Wang ◽  
Jun Yang ◽  
...  

Abstract Background It is rare that drains cannot be removed after surgery, however, this situation cannot be completely avoided, and is also hard to deal with. The main reason for a tethered drain is inadvertent suture fixation. At present, no effective way was published or widely accepted to locate the tethered drain. Methods Three cases of orthopedic trauma patients experienced unsuccessful removal of the drain after surgery. The ultrasound was used to locate the sutured site of the drain. Based on the sliding sign and vanishing point which can be detected by the ultrasound, the sutured site of the drain can be clearly identified. Finally, the suture was loosened through a small incision, and the drain was completely removed. Results The surgical procedure was very successful in all patients. The tethered drain was quickly and completely removed through a small incision with locating by ultrasound. Intravenous antibiotics were administered within 24 h after surgery, and no wound or deep infections occurred. Conclusions Ultrasound can be used to locate a tethered drain based on the sliding sign. This method can simplify the release procedure and achieve fast removal of the drain. Furthermore, it will help lower the risk of a retained drain and soft tissue complications.


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