Flashcards in Dead space and drainage Deck (33)
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1
What is dead space?
a space formed between tissues that are normally anatomically connected
2
What do dead spaces most commonly fill with?
fluid, sometimes gas
3
What causes dead space?
excessive dissection during surgery or trauma--separation of tissues
4
What is the classic case of trauma that causes dead space?
big dog picks up little dog by scruff and shakes
5
What can create dead space during surgery?
1. poor technique #1
2. mass removal
3. reconstruction
6
What is a seroma?
collection of serum in a tumor like mass
7
Why do we want to avoid dead space?
1. slows healing (can't get fibrin bridge; blood supply compromised)
2. increases risk of infection of the wound--(rich nutrients in seroma)
8
How do you minimize dead sapce?
1. meticulous minimalist technique
2. mayo disseciton
3. remove only target tissue
9
How do you manage dead sapce?
1. layered wound closure
2. tacking sutures
3. compression bandage
4. drainage
10
Where should you use surgical drainage?
where there is significant dead space or where expect fluid to accumulation cand cause a problem
11
Where should you not use drainage?
where the wound shouln't be closed around a drain
1. contamination
2. more debridement required
12
Why is it pointless to sitck a drain in an abscess of guinea pigs, rabbits or birds?
their pus is too viscous
13
How do passive drains work?
they use capillary action, gravity and/or pressure gradients to remove fluid
14
What is a penrose drain?
the most commonly used passive drain in vet med
15
How do passive drains work?
they use capillary action, gravity and/or pressure gradients to remove fluid. the entire tubing acts as a slide.
16
What is a penrose drain?
the most commonly used passive drain in vet med
17
How do you use a penrose drain?
1. rinse with sterile saline to remove powder
2. have a ventral exit that is NOT part of the incision or wound
3. cover!!!
4. tack in place with a suture or two at exit site
5. make sure exit wound is large enough that it will stay open ntil next bandage change
6. don't lose it in the wound
18
how do active drains work?
they use suction to remove fluid
19
Why do active drains need to have a closed system?
because suction needs to be generated
20
What is a "rocket pack"?
An active drain made with a butterfly catheter and red rubber tubes or a syrynge with a plunger fixed in place
21
Which should be fenestrated, active or passive tubes?
active NOT passive
22
What is a ready made active drain?
Jackson Pratt
23
How is the active drain fixed to the skin?
finger trap pattern
24
Why does the collection system of an active drain need to be emptied using sterile technique?
because any contamination of the collection system means that bacteria will gain entry and crawl up the tubing into the wound
25
What is compression directly and inversely correlated to?
1. direct: tension, layers
2. width, radius of limb
26
What can cause blockage of a drain?
dibrin
27
What can cause blockage of a drain?
fibrin
28
When shoudl drains be removed?
when the quantity of fluid retrieved has decreased and leveled off and the quality of the fluid is clear (
29
What are three specialized drainage techniques?
1. omentization
2. open wound drainage
3. vacuum assisted closure
30
