RU42957U1 - DRAINAGE DEVICE - Google Patents

Abstract

The utility model relates to surgery and is intended for active-washing drainage of wounds and body cavities. The drainage device consists of two elastic tubes sequentially connected to each other through a hollow adapter: a direct outlet tube with side holes and a smaller lead diameter, made in the form of a cylindrical coil spring and wound around the outlet with a total diametrical gap between the tubes of 10-15 mm. A longitudinal air tunnel passes through the wall of the discharge tube. On the inner surface of the drive tube there are side openings. A drainage device improves drainage efficiency and speeds up the elimination of the inflammatory process.

Description

The utility model relates to medicine, namely to surgery, and is intended for active-washing drainage of wounds and body cavities.

Known surgical drainage (autosw. SU No. 1793935, A61M27 / 00, published in Bull. No. 5 for 1993, 02/07/93) for simultaneous irrigation and drainage, consisting of an external perforated tube with a formed screw through channel and a movable inner tube installed inside it with side openings and traps for blood clots. The diameter of the holes of the outer tube is less than the diameter of the holes of the inner tube, the width of the screw channel is equal to the diameter of the holes of the outer tube. A sleeve is attached to the proximal portion of the outer tube to prevent the screw channel from diverging.

The disadvantages of this drainage are:

the impossibility of simultaneous irrigation and aspiration during drainage;

the inability to adapt the device to the shape and size of the drained cavity due to the rigid fixation of the drainage structure elements;

small drained area, lack of prevention of encapsulation of drainage and the possible closure of holes in the outer tube by the falling walls of the cavity;

- the lack of conditions for the rejection of sequestered tissues larger than the diameter of the drainage tubes;

- the impossibility of irrigation of the drained cavity along the entire length of the drainage. The closest in purpose and combination of essential features is a device for drainage of the abdominal cavity (ed. St. RLJ No. 2160609, A61M27 / 00, dated 07.06.99, publ. 20.12.00), consisting of two silicone tubes with side holes, through additional openings of one of the tubes will be helically conducted by a hydraulic hose of smaller diameter, equipped with slit-like openings, the distal end of the device is equipped with a swelling cuff with an air duct connected to it.

To prevent encapsulation of drainage in the postoperative period several times a day, cuffs are inflated at the end of the drainage by supplying air through the duct in a volume of 20-60 ml, and in a hydraulic hose under pressure of 4-6 atm. an antiseptic solution is supplied, which flows through the slit-like openings in the form of thin radial jets.

The disadvantages of this device are:

- the impossibility of conducting active-flushing drainage due to the lack of an air duct opening into the drained cavity;

- the lack of a system for the continuous prevention of encapsulation of drainage and the need to perform several times a day the introduction of an antiseptic solution into the hydraulic hose under pressure and inflate the cuff;

- reducing the working space of the drainage tube due to the multiple passage of a hydraulic hose through it, which reduces the effectiveness of the drainage;

- the inability to adapt the device to the shape and size of the drained cavity due to the rigid fixation of the structural elements of the drainage;

- lack of conditions for the rejection of sequestered tissues that are larger than the diameter of the drainage tube;

- the possibility of trauma to surrounding tissues with a hydraulic sleeve when removing drainage.

Tasks solved by the utility model:

- create conditions for active-flushing drainage by simultaneously irrigating the drained cavity and aspirating its contents;

- create conditions for uniform irrigation of the drained cavity with antiseptics;

- create conditions to maintain a constant volume of the drained cavity, the maximum drained surface and prevent encapsulation of drainage;

- create conditions for a constant free outflow of exudate and wash fluid, as well as the rejection of sequestered purulent-necrotic tissue from the drained cavity;

- create conditions for painless safe drainage removal. The proposed drainage device consists of two elastic tubes: a direct outlet pipe with side openings and a smaller diameter lead, made in the form of a cylindrical coil spring and wound around the outlet pipe with a gap. In this case, the tubes are connected in series through a hollow adapter. The total diametrical clearance between the tubes is 10-15 mm. A longitudinal air tunnel passes through the wall of the discharge tube. On the inner surface of the drive tube there are lateral openings facing the discharge tube.

The proposed drainage device differs about the prototype in that:

- there is an active-flush drainage system with an air tube;

- the inlet tube is made in the form of a cylindrical coil spring and is wound on the outlet with a gap, while the tubes are connected in series through a hollow adapter;

- there is a total diametrical clearance between the tubes equal to 10-15 mm;

- an air tunnel passes through the wall of the outlet tube;

- side openings in the inlet tube are located on its inner surface facing the inlet tube.

The simultaneous irrigation of the drained cavity and aspiration of its contents, i.e. active-washing drainage is carried out through the separate use of a screw tube for introducing a washing solution, and a direct inner tube with an air-water tunnel for aspirating exudate and washing solution.

Maintaining a single cavity with a maximum drained area is ensured by the elasticity of the tubes and the special properties of the screw tube. The elasticity of the tubes and the execution of the inlet tube in the form of a cylindrical helical spring wound around the outlet with a gap allow twisting to reduce the overall outer diameter of the drainage device and to model it as much as possible in shape and size of the drained cavity. At the same time, due to its elasticity and the ability to maintain its original shape, the helical tube serves as a frame for the drained cavity, which prevents its walls from falling off and keeps the drained surface maximum. The distance between the turns and the change in the diameter of the winding of the screw tube can be adjusted by changing the clearance and stretching of the supply tube, which provides free tearing of sequesters.

The gap between the tubes and the distance between the turns provide free constant access of exudate with detritus and flushing fluid to the discharge tube. The drainage channel, formed due to the gap between the tubes, provides for washing to remove sequesters that form during purulent-necrotic inflammation. The implementation of the total diametrical gap equal to 10-15 mm, ensures the maintenance of the frame properties of the drainage device, despite the possible radial oscillations of the gap inside the drained cavity.

The location of the holes in the inlet tube on the surface facing the outlet tube prevents them from being closed by the walls of the drained cavity and provides effective irrigation.

Due to the serial connection of the ends of the tubes through the hollow adapter and the location of the side holes along the entire length of the drive tube with active

washing drainage ensures the passage of the washing solution along the entire length of the supply tube and uniform irrigation of the entire drainable cavity with antiseptic solutions.

The design of the drainage device is illustrated in figure 1.

In the drainage device (FIG. 1), the lead tube 1, made in the form of a coil spring, is put on the discharge tube 2 having side holes 4. The tubes 1 and 2 are connected in series through the hollow adapter 5. This creates a gap between the tubes. In the wall of the outlet tube there is a longitudinal air-water tunnel 6. On the inner surface of the outlet tube there are side openings 3 facing the outlet tube.

The drainage device is used as follows:

Due to the elasticity when installing the drainage device, its shape is adjusted to the shape and size of the drained cavity. The device is installed in a drained cavity, and the free ends of the tubes are brought out. An infusion system with an antiseptic solution is connected to the end of the supply tube. A vacuum tube is connected to the end of the discharge tube. Active-flushing drainage of the required duration and frequency is carried out.

When removing the drainage device, it is reduced by twisting along the helical diameter of the inlet tube to the diameter of the outlet tube. Then the device is freely pulled from the formed drainage channel.

Example 1. Patient S., 74 years old (medical history No. 10689), was taken to a hospital with a diagnosis of severe pancreatic necrosis, common parapancreatitis, enzymatic peritonitis. Under general anesthesia performed median laparotomy. In the abdominal cavity, a hazy hemorrhagic effusion. There is edema, infiltration, turbid hemorrhagic impregnation of parapancreatic fiber with spread to the root of the small intestine, perinephral and paracolic tissue. Gastrointestinal ligament dissected. Several sections of black necrosis were revealed in the body of the pancreas ranging in size from 1.5x1.5 to 3.0x3.0 cm. The peritoneum was dissected along the upper and lower edges of the pancreas, the duodenum was mobilized according to Kocher, and the ascending and descending sections of the colon with an autopsy were mobilized. perinephral spaces. Four drainage devices are installed in the formed cavities in the retroperitoneal tissue in accordance with the shape and size of the drained cavities. The free ends of the tubes of the drainage devices are brought out through additional incisions in the hypochondria and iliac regions on both sides. The laparotomic wound is sutured in layers. In the postoperative period

continuous active-washing drainage with the introduction of a solution of furacilin and dioxidine. Serous-hemorrhagic and serous-purulent exudate was aspirated through the drains, and 6 days after the operation, sequestra of the pancreas and retroperitoneal tissue 1.0x1.5x1.5 cm in size began to be rejected through the formed drainage channels. The outflow of exudate and rejection of tissue detritus continued through the drainage channels for 8 weeks. Then the drainage devices are painlessly and without technical difficulties removed after twisting the screw tubes. The patient was discharged after 68 days from the time of admission in satisfactory condition.

Medical and social effectiveness is:

- to increase the efficiency of drainage and the reliability of the device;

- in accelerating the elimination of the inflammatory process over the entire area of the pathological focus due to the adequate removal of exudate and necrotic tissue, as well as bringing antiseptic agents to the area of inflammation.

Claims (5)

1. A drainage device consisting of two elastic tubes with side openings, one of which is a direct outlet, the second, a smaller diameter, curved helically, inlet, characterized in that the inlet tube is made in the form of a cylindrical helical spring and is wound on the outlet with a gap, with this tube is connected in series with each other. 2. The drainage device according to claim 1, characterized in that the tubes are connected through a hollow adapter. 3. The drainage device according to claim 1, characterized in that the total diametrical clearance is 10-15 mm. 4. The drainage device according to claim 1, characterized in that in the wall of the discharge tube there is a longitudinal airway tunnel. 5. The drainage device according to claim 1, characterized in that the side openings in the inlet tube are located on its inner surface facing the outlet tube.