RU196856U1 - WOUND DRAINAGE AFTER THE MUSCULAR PLASTIC OF THE BREAST WALL - Google Patents

Abstract

The invention relates to the field of medicine, and can be used in thoracic surgery to drain the wound after muscle plasty of the chest wall. Drainage of the wound after muscle plasty of the chest wall, having perforations, characterized in that it is a system of communicating central and two semicircular tubes in the form the Russian letter "F", while through the Central tube can be held fishing line-conductor; on the outer surface of the tube there are annular marks for successively crossing and removing drainage from the wound: the first mark is applied to the proximal part of the central tube below the place of its communication with two semicircular tubes; a second mark is applied to the proximal part of one semicircular tube below its connection to the central tube; a third mark is applied to the distal part of another semicircular tube above its connection to the central tube. 1 ill.

Description

The utility model relates to the field of medicine, and can be used in thoracic surgery to drain wounds after muscle plasty of the chest wall.

Known drainage, which is a tube perforated in the proximal part, which is installed in the area of operation, while its distal part is brought to the surface of the body and connected to a vacuum (1). The disadvantage of this type of drainage is the impossibility of flow-through washing when it is occluded with fibrin or a blood clot, which creates the prerequisites for infection of the wound. Drainage located directly under the muscle flap excludes the possibility of collecting exudate and draining all areas of the operation after the chest flap with a muscle flap.

A known type of drainage in the form of a tube, which has several perforations at an equal distance from its edges. At the same time, it is positioned in such a way that the holes are in the wound area, and both ends of the tube are brought to the surface of the body through contra-holes. Thus, the only through drainage is located under the muscle flap, which allows washing the wound with an antiseptic solution in the postoperative period (2). However, the tube is not able to drain the lateral areas of the chest wall after mobilization of the edges of the wound, which can cause accumulation of exudate and infection of the wound. We took this drainage as a prototype.

The technical result of the utility model is the creation of drainage for effective drainage of all areas of the operation after plasty of the chest wall with a muscle flap.

This technical result is achieved in that the drainage is a system of interconnected central and two semicircular tubes in the form of the Russian letter "F", while a conductor line can be drawn through the central tube; on the outer surface of the tube there are annular marks for successively crossing and removing drainage from the wound: the first mark is applied to the proximal part of the central tube below the place of its communication with two semicircular tubes; a second mark is applied to the proximal part of one semicircular tube below its connection to the central tube; a third mark is applied to the distal part of another semicircular tube above its connection to the central tube.

To eliminate the defect of the chest wall and suturing the skin above it, a sufficiently extensive mobilization of the tissues of the chest wall on both sides of the defect edge is required. The areas of mobilized tissues of the chest wall, which are located laterally from the edge of the defect, need active drainage to prevent the accumulation of exudate and infection. A feature of the proposed drainage is the ability to simultaneously drain both the space under the muscle flap and the chest wall after extensive tissue mobilization.

The proposed drainage design makes it possible to most adequately evacuate exudate from all areas of surgical intervention due to the location of the central drainage tube under the muscle flap directly in the defect of the chest wall, and two semicircular tubes under the mobilized tissues on both sides of the defect of the chest wall. The presence of annular marks on the outer surfaces of the tubes allows them to successively cross and remove drainage from the wound. After drainage is removed, a through-line conductor, which is located earlier in the central tube, remains in the wound in order to control the amount of exudate to be separated after drainage is removed.

Comparison of the proposed device with others known in the field of medicine, shows its compliance with the criteria of a utility model. Drainage is a system of interconnected central and two semicircular tubes in the form of the Russian letter "F", while a fishing line can be drawn through the central tube; on the outer surface of the tube there are annular marks for successively crossing and removing drainage from the wound: the first mark is applied to the proximal part of the central tube below the place of its communication with two semicircular tubes; a second mark is applied to the proximal part of one semicircular tube below its connection to the central tube; a third mark is applied to the distal part of another semicircular tube above its connection to the central tube.

The utility model is illustrated by graphic material. The figure 1 shows: 1 - the Central tube; 2 - semicircular tubes; 3 - perforation holes; 4 - the first mark; 5 - second mark; 6 - third mark; 7 - fishing line conductor.

The proposed "F" -shaped drainage is used as follows. After cutting out the muscle flap and before moving it to the area of the defect of the chest wall, mobilize the tissues of the chest wall in the lateral direction from two sides to allow the wound to be sutured over the muscle flap without tensioning the tissues. The drainage is positioned in the wound so that the central tube is under the muscle flap, and the semicircular tubes are under the mobilized tissues on both sides of the chest wall defect. A conductor fishing line is placed in the lumen of the central tube. The proximal end of the central tube brought to the surface of the body is hermetically sealed with an obturator, and the distal end of the tube is connected to a Redon-type drainage for active vacuum aspiration. To remove drainage in the postoperative period, the following manipulation is performed. The proximal end of the central tube is pulled out until the first mark appears in the wound, one semicircular tube is crossed immediately after it leaves the central tube, after the central tube is crossed immediately below the departure of both semicircular tubes in the second mark, after which the distal part of the drainage is pulled out until it appears in the wound the third mark, cross another semicircular tube immediately after its departure from the central tube, a fishing line-conductor is left in the wound to drain the remaining wound on discharge.

A 60-year-old patient S. with a diagnosis of type 1 post-sternotomy mediastinitis according to Oackley-Wright after an acute inflammatory process was stopped, an operation was performed: resection of the sternum, cartilaginous parts of 4-7 ribs on both sides, plastic with a vertical rectal flap, drainage of the wound “F” - figurative drainage. The drainage was removed on the 3rd day, the fishing line-conductor was removed on the 4th day. The drainage was quickly placed intraoperatively, allowed adequate drainage of all areas of surgical intervention and the lung was removed in the postoperative period. Wound healing was the primary intention. Plastic is effective. The patient was discharged in satisfactory condition.

It is advisable to use the utility model when draining the wound after muscle plasty of the chest wall in the surgical thoracic departments.

SOURCES OF INFORMATION

1. Surgical treatment of postoperative purulent sternomediastinitis / Yu.V. Belov, R.N. Komarov, S.V. Chernyavsky, I.V. Reshetov, P.V. Nail // Surgery. Magazine them. N.I. Pirogov. - 2015. - No. 7. - S. 85-87.

2. Surgical treatment of purulent chondritis and osteomyelitis of the ribs and sternum / V.V. Grubnik, P.P. Shipulin, S.A. Passage, V.M. Kravchenko. // Thoracic and cardiovascular surgery. - 1997. - No. 4. - S. 39-43.

Claims (1)

Drainage for a wound after muscle plasty of the chest wall, having perforations, characterized in that it is a system of communicating central and two semicircular tubes in the form of the Russian letter "F", while the central tube is made with the possibility of passing through it fishing line; on the outer surface of the tubes there are annular marks for successively crossing and removing drainage from the wound: the first mark is applied to the proximal part of the central tube below the place of its communication with two semicircular tubes; a second mark is applied to the proximal part of one semicircular tube below its connection to the central tube; a third mark is applied to the distal part of another semicircular tube above its connection to the central tube.

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