RU66957U1 - VACUUM DRAINAGE - Google Patents

Abstract

The utility model relates to medicine, in particular to surgery, and can be used in the postoperative management of closed non-purulent wound cavities, the prevention of infectious complications after surgical interventions and wounds.

The objective of the proposed utility model is to improve the drainage process, which would ensure the effective emptying of wounds and cavities from accumulated exudate, which would maximally meet the physiological needs of the drained area. The problem is solved due to the fact that a pear from a manual enema is used as a vacuum chamber, which, on the one hand, is connected to a drive tube coming from the wound cavity through a connecting tube and an adapter tee, to which through an air-aspiration filter containing filter layers paper, and 2 insertion tubes connected a bulb from a hand tonometer with 2 inverted air valves, and on the other through a standard water valve from an Esmarch mug and an outlet tube with a sealed container for failure exudate, equipped with 2 built-in tubes, one of which is connected to an air decompression filter containing inner and surface layers of filter paper, and the other is a sealing element fixed to the outlet tube, in addition, one of the inverted air valves has an air a valve for air inlet into the pear from the hand tonometer, in addition, the connecting tube is fixed to the pear from the manual enema using a fitting, and the sealing element is connected to one of the built-in tubes of the sealed container spills for collecting exudate using a fixing strip, and the sealing element of the container for collecting exudate is made of an injection syringe element and is equipped with a syringe piston.

The proposed vacuum drainage allows you to: easily adjust the strength of the active aspiration of the wound discharge, actively use the patient’s participation in the drainage and drainage control process, free

the staff and the patient from the need for additional manipulations and actions to remove the drainage, disconnect and charge its parts, ensure the continuity of drainage with the participation of the patient throughout the treatment period, apply several effective aspiration regimes, making adjustments and changing the treatment plan.

Description

The utility model relates to medicine, in particular to surgery, and can be used in the postoperative management of closed non-purulent wound cavities, the prevention of infectious complications after surgical interventions and wounds.

The known method / see Atlas of drainage in surgery, M.I. Gulman, Yu.S. Vinnik, S.V. Miller, Krasnoyarsk, 2004, pp. 18-19 /, which consists in the drainage of the wound by double-lumen drainage and programmed washing of the wound with simultaneous dosed vacuum aspiration by a vibroaspirator. However, this method is technically complicated, cumbersome and volatile, as it requires the connection of an electric vibrator, and also damages the walls of a sealed wound cavity due to the excess negative pressure that the vibrator creates. In addition, the operation of this device necessitates a constant stay of the patient in bed for the entire period of drainage, which postpones the activation of the patient in the postoperative period.

Closest to the proposed principle of action is the method / See Kuzin M.I. Kostyuchenok B.M. Wounds and wound infection, Moscow, “Medicine”, 1990, p.260 / drainage of closed wound cavities using a device, which is a plastic “accordion” of various volumes, connected to the wound cavity by means of a pyrogen-free PVC tube, operating on the principle of rarefaction, created by squeezing an accordion. However, this drainage, in spite of all its simplicity, needs to be disconnected from the accordion during the next charging of the drainage, which requires additional effort, time, attention of the medical staff to a specific patient. In addition, this method does not provide continuous continuous creation and control over the vacuum of the drained area and

It works with the presence of time intervals when the wound cavity communicates with atmospheric air, which creates undesirable effects in postoperative wound management. In addition, the next time you charge this drainage, there is no proper sterility, hygiene.

The objective of the proposed utility model is to improve the drainage process, which would ensure the effective emptying of wounds and cavities from accumulated exudate, which would maximally meet the physiological needs of the drained area.

The task is achieved due to the fact that a pear from a manual enema is used as a vacuum chamber, which, on the one hand, is connected to a drive tube coming from the wound cavity through a connecting tube and an adapter tee, to which, using an air-aspiration filter, containing filter layers paper, and 2 insertion tubes connected a bulb from a hand tonometer with 2 inverted air valves, and on the other through a standard water valve from Esmarch’s mug and a discharge tube with a sealed container for collection of exudate, equipped with 2 built-in tubes, one of which is connected to an air decompression filter containing inner and surface layers of filter paper, and the other is a sealing element fixed to the outlet tube, in addition, one of the inverted air valves has an air a valve for letting air into the pear from the hand tonometer, in addition, the connecting tube is fixed to the pear from the manual enema using a fitting, and the sealing element is connected to one of the built-in tight tubes containers for collecting exudate using a fixing strip, and the sealing element of the container for collecting exudate is made of an injection syringe element and is equipped with a syringe piston.

Simplicity, reliability, compactness makes this drainage indispensable in the clinical practice of treating surgical pathology in Russian hospitals. The technical structure of the proposed utility model, the presence of several effective easily adjustable operating modes ensures the active participation of the patient in the drainage process, and also allows you to program the drainage in accordance with the treatment plan of specialists.

The above allows us to assume that the claimed utility model has qualities that differ from the known solutions, and therefore, the proposed drainage has "significant differences".

The proposed utility model is shown in Figure 1: 1 - a pear from a manual enema; 2 - fitting; 3 - connecting tube; 4a, 4b — insertion tubes; 5 - air-suction filter; 6a, 6b - layers of filter paper 7 - air-driven valve; 7a - air valve; 8 - air outlet valve; 9 - a pear from a manual tonometer; 10 - plastic adapter (tee); 11 - a driving tube; 12 - wound cavity; 13 - standard water valve from Esmarch's mug; 14 - outlet pipe; 15 - element of an injection syringe; 16 - fixing gasket; 17a, 17b - integrated tubes; 18 - air decompression filter; 19 - additional surface filter layers; 20 - sealed container for collecting exudate; 21 - syringe piston.

A triple adapter (10), taken from the Redon drainage, connects the drive tube (11) to the connecting tube (3) going to the pear from the manual enema (1) and the insertion tube (4b) of the air-aspiration filter (5). The air-suction filter (5), made from the body of the syringe with the flaps of mask paper (6a) tightly lying in several layers, is connected on one side to the triple adapter (10) via an insertion tube (4b), and on the other - to the pear from the hand tonometer (9) by means of the insertion tube (4a). For complete tightness of the mask paper flaps (6a), it is advisable to first throw them in several layers on both short insertion tubes (4a, 4b) adjacent to the air-suction filter (5), and then carefully screw them into the filter housing. The pear from the hand tonometer (9) is equipped with 2 unidirectional air valves, one of which, the air-driven valve (7), has an air valve (7a) for dosed intake of atmospheric air into the pear and is connected to the air-aspiration filter (5) through an insertion tube (4a), and another, air-outlet valve (8), is designed to release air into the atmosphere. The connecting tube (3) is hermetically fixed to a pear from a manual enema (1) using a fitting (2) which is a syringe housing devoid of a piston,

shortened by removing the part where the bottom with the syringe-needle connection is located. The fitting (2) is inserted into the bulb (1) through a specially created hole corresponding to the diameter of the syringe body, and hermetically welded to the pear with its ears immersed inside its cavity and adjacent to the inner side of its wall. Outside, the fitting (2) is fixed to the pear (1) by stringing a tube on it having a slightly greater strength than the rest of the tubes, thickness and diameter, followed by tight pressing it against the wall of the pear. The standard water valve from the Esmarch's mug (13) is inserted on one side into the bulb bulb from a manual enema (1), and on the other it is connected to a sealed container for collecting exudate (20) via an outlet tube (14). A sealed container for collecting exudate (20), made in the form of a soft bag for blood transfusion, equipped with two built-in tubes of different diameters (17a, 17b), is connected with a bypass tube (14) through an injection syringe element (15). At the same time, the injection syringe element (15), made in the likeness of the nozzle (2) with a longer body, is firmly fixed with its lower end (without ears) to one of the thin built-in tubes (17a) using a fixing strip (16) made of PVC tubes of the desired diameter. With its upper end (with ears), an injection syringe element (15) is connected to a bypass tube (14). The use of a syringe element (15) is necessary to seal the container for collecting exudate (20) after filling it and disconnecting it from the working units of the drainage system. To do this, after closing the water valve (13) and removing the container for collecting exudate (20), you need to use a syringe piston (21) attached to it with a thread or rubber band, inserting and pressing it into the body of the injection syringe element (15). An air decompression filter (18) is attached to the second built-in tube (17b) with its nose, made of a shortened syringe body and laced into it, lying tightly in 2-3 layers of mask paper flaps (6b) with an additional stringing of 2-3 surface filter layers (19), mounted on it with durable rubber.

The proposed drainage works as follows. The wound fluid, leaving the wound cavity (12), enters the tee through the drive tube (11)

(10). Further, the movement of exudate occurs in 2 ways: either through a tube (3) into a pear from a manual enema (1); or towards the pear from the hand tonometer (9), meeting the resistance of the layers of filter paper (6a) of the air-suction filter (5). In this case, only purified air is filtered, and the wound fluid itself enters through the connecting tube (3) into the pear from a manual enema (1). After active deposition in a pear from a manual enema (1), the wound detachment bypasses the water valve (13) and enters through an outlet tube (14) into a sealed container for collecting exudate (20), equipped with an air-decompression filter (18). The air decompression filter (18) protects the sealed container for collecting exudate (20) from overstretching by air coming from a pear from a manual enema (1) when it is being charged, while not allowing wound fluid to leak out due to the presence of internal (6b) and outer (19) layers of filter paper. It should be noted that the insertion tube (4b) serves only for the tight connection of the air-suction filter (5) with a tee (10). Therefore, its length should be minimal so that wound exudate does not accumulate and stagnate in its lumen, since the only way to move it is towards the pear from the manual enema (1), and the pear from the manual tonometer (9) serves only as an additional source vacuum, which controls the active vacuum in the drainage system and the charge level of the main bulb (1).

Drainage includes 3 operating modes that can be used depending on the patient’s condition, treatment plan: passive aspiration mode - in this case, after installing the drainage, you just need to open the water valve (13), and thus provide weak active aspiration of the exudate from the wound cavity (12 ) due to the hydrodynamic force of the passive outflow of wound separated from the pear from the manual enema (1), which pulls the fluid located in the wound cavity; long-term active aspiration mode - this mode is carried out by squeezing the pear balloon from a manual enema (1) followed by closing the water valve (12) and provides long-term vacuum aspiration of the wound discharge by expanding the walls of a larger pear from a manual enema (activate this mode work can be both a doctor and the patient himself); short active aspiration mode - in

in this case, the wound is aspirated by pumping a pear from a hand tonometer (9), both with a closed and an open water valve (13). In this case, a shorter time active vacuum force arises, which the patient supports at will, thus facilitating the drainage process and controlling the operation of the main pear (1) by charging it additionally with the water valve closed (12), which also does not let air through .

It should be noted that the bulb from the hand tonometer (9) will work only when the air valves (7, 8) inserted into it are turned upside down and installed at the other end. At any time, the patient can stop the operation of the pear from the hand tonometer (9) at the stage of its expansion by opening the air valve (7a) of the air-drive valve (7) and launching atmospheric air into the pear. With the same valve, he can regulate the power and duration of the pear from the hand tonometer (9) to create an active vacuum, increasing or decreasing the flow of atmospheric air into it. Thus, finer regulation of the active vacuum in the drainage system occurs. The patient, guided by the recommendations of the attending physician, follows the most effective quantitative and qualitative mode of operation of pears. Moreover, the feature of the proposed system is that the active vacuum created by the pear from the hand tonometer (9) is maintained for a certain time after the patient stops working due to the expansion of the pear from the manual enema (1), charged to various degrees for swing time of a smaller pear (9). After the pear is finished from a manual enema (1), it is necessary to transfer it to the passive aspiration mode by opening the water valve (13) to drain the wound fluid into a sealed container to collect exudate (20). In this case, the patient can, without ceasing to use the pear from the hand tonometer (9), aspirating the liquid from the wound and further helping the wound discharge from the pear from the manual enema (1) into a sealed container for collecting exudate (20) by raising the air flow in the opposite direction .

The principle of operation of vacuum drainage is based on the active vacuum suction of the wound discharge through the force of automatic return

the elastic walls of pears of various sizes and durations, controlled and controlled from the outside, as well as on weak active aspiration of wound exudate under the influence of hydrodynamic force created in a larger pear.

Drainage is carried out with the aim of forced outflow of the wound discharge, creating negative pressure in the wound with the aim of sticking together its edges and improving its repair, creating an anaerobic environment for the prevention of aerobic infection.

The effectiveness of vacuum aspiration can be judged by clinical data, the patient’s condition, laboratory data and local status, as well as data from x-ray and fistulography. The timing of the use of drainage is set by a specialist depending on the nosology, clinical picture.

The advantages of this system are: 1) easily adjustable force of active aspiration of the wound discharge; 2) the active participation of the patient in the process of drainage and drainage management; 3) the absence of the need for additional manipulations and actions to remove the drainage, disconnect and charge its parts; 4) the continuity of work with the participation of the patient throughout the duration of treatment; 5) multi-mode operation, allowing you to make adjustments and change the treatment plan.

Claims (5)

1. A vacuum drainage containing a vacuum chamber and a drive tube connecting the vacuum chamber to the wound cavity, characterized in that a pear from a manual enema is used as a vacuum chamber, which, on the one hand, is connected to a drive tube coming from the wound cavity through a connecting tube and a tee adapter, to which, using an air-suction filter containing layers of filter paper and 2 insertion tubes, a pear is connected from a hand tonometer with 2 inverted air valves, and on the other, through a standard water valve from the Esmarch mug and the outlet tube with a sealed container for collecting exudate, equipped with 2 built-in tubes, one of which is connected to an air-decompression filter containing internal and surface layers of filter paper, and to the other a sealing element fixed to outlet pipe. 2. The vacuum drainage according to claim 1, characterized in that one of the inverted air valves has an air valve for admitting air into the bulb from the hand tonometer. 3. The vacuum drainage according to claim 1, characterized in that the connecting tube is fixed to the pear from the manual enema using a fitting. 4. The vacuum drainage according to claim 1, characterized in that the sealing element is connected to one of the built-in tubes of the sealed container to collect exudate using a fixing strip. 5. The vacuum drainage according to claim 1, characterized in that the sealing element of the container for collecting exudate is made of an injection syringe element and is equipped with a syringe piston.