BARD CLOSED WOUND DRAINAGE

Transcription

1 BARD CLOSED WOUND DRAINAGE CLOSED WOUND SUCTION GRAVITY DRAINS SUMP DRAINS Reference Guide - Advancing Lives and the Delivery of Healthcare

2 What Is a Wound? A wound drain is typically a plastic tube that provides a way for unnecessary body fluids or air to flow out of the body from a wound. The purpose of the drain is to remove fluid and/or blood from the area of surgery. This helps the healing process. One end of the wound drain is placed within the wound and the other end may be connected to a suction collection device. The fluid may be collected in a drainage bag, plastic bulb, plastic carton, or onto a dressing. wound_drain.htm What Types Of Surgeries Are Wound s Commonly Used In? Surgical Procedure Surgical Small Bore Large Bore x2 s TOTAL HIP REPLACEMENT ORTHO X TOTAL KNEE REPLACEMENT ORTHO X X SPINE ORTHO/NEURO X CRANIOTOMY NEURO X RADICAL MASTECTOMY GENERAL X X X PARTIAL MASTECTOMY GENERAL X X ABDOMINAL GENERAL X X COLON GENERAL X GASTRIC RESECTION GENERAL X APPY GENERAL X EPIGASTRIC HERRNIA GENERAL X ABDOMINOPLASTY GEN/PLASTIC X X BREAST REDUCTION PLASTIC X X RADICAL NECK ENT X X THYROIDECTOMY ENT X X What Type Of s Does Bard Have For These Types of Surgeries? Bard has Channel drains, perforated silicone and PVC drains. These are typically attached to a suction device. This could be a bulb evacuator, a three-spring evacuator or wall suction. Common terms you may here are: n Bulb Evacuator n Grenade, JP n Three Spring Evacuator n Pancake To attach the drain to the evacuator you may need to use an adapter. Many of our drains are packaged with multiple adapters. Why? The different adapters typically allow you to connect to both Silicone and PVC evacuators Extra adapters may be provided to allow the user to connect multiple drains to an evacuator (example - double round drains) Basic Overview To determine if an adapter is needed, you will need to know some basic information.. What are the drain and evacuator made out of? 2. What is the size of the drain?. For PVC evacuators, what type of Y-Connector are you using? 4. Are you using a kit?

3 . Type of Materials s and evacuators are made out of either silicone or PVC. Here are examples of our products. DRAINS SILICONE EVACUATORS DRAINS PVC EVACUATORS 2. Size of The general rule of thumb says when connecting like materials, no adapter is needed. Silicone g Silicone Bulb Evacuator g Typically No Adapter Required The Exception: If the drain is very large or very small, an adapter is needed to fit it on the evacuator General Rules- When do I use an adapter? Connecting like material requires no adapters DRAIN SIZE ADAPTER REQUIRED? TYPE OF ADAPTER /2in, /8in 0Fr Yes Silicone g Silicone Bulb Evacuator g No Adapter Required PVC g PVC Evacuator (-Spring/Reliavac Evacuator) g No Adapter Required Connecting unlike material requires an adapter Silicone g PVC Evacuator (-Spring/Reliavac Evacuator) g Adapter Always Required /6in, /4in 5Fr, 9Fr, 0mm, 7mm 9Fr (Channel Hubless Round) 24Fr,28Fr,2Fr No Yes. Type of Evacuator Y-Connector Once again, the general rule of thumb says when connecting like materials, no adapter is needed. PVC g PVC Evacuator (-Spring/Reliavac Evacuator) g No Adapter Required The Exception: If you use a Reliavac evacuator, an adapter may be needed The reason, the Three Spring Evacuator has a Crab Claw Y-connector that can be cut to customize the end to fit the PVC drain 4. Are you Using a Kit? Many of our kits are customized for the type of drain and evacuator. The appropriate adapter may already be attached. In the case of the Reliavac evacuator, the kits may actually have a smaller Y- connector that is customized for the drain. In this case an adapter is not needed. If not, use the rules defined above. The Reliavac evacuator does not

4 Channel s Following is detail information about what adapters come PART NUMBER DRAIN SIZE DRAIN MATERIAL DRAIN SHAPE PERFORATED/ FLUTED TROCAR DOT MARKER NUMBER OF ADAPTERS Fr Silicone Channel Round Full Dot Fr Silicone Channel Round Full /8 in Dot Fr Silicone Channel- Round Hubless Full Dot Fr Silicone Channel- Round Hubless Full /8 in Dot Fr Silicone Channel Round /4 /8 in Dot mm Silicone Channel Flat /4 Dot mm Silicone Channel Flat Full Dot mm Silicone Channel Flat Full /6 in Dot mm Silicone Channel Flat /4 /6 in Dot Fr Silicone Channel Round Full Dot Fr Silicone Channel Round Full /6 in Dot Fr Silicone Channel Round /4 /6 in Dot Fr Silicone Channel- Round Hubless Full Dot Fr Silicone Channel- Round Hubless Full /6 in Dot Fr Silicone Channel Round Full Dot Fr Silicone Channel Round Full /6 in Dot Fr Silicone Channel Round Full /4 in Dot Fr Silicone Channel Round /4 /6 in Dot Fr Silicone Channel- Round Hubless Full Dot Fr Silicone Channel- Round Hubless Full /4 in Dot Fr Silicone Channel- Round Hubless Full Dot Fr Silicone Channel- Round Hubless Full N Fr Silicone Channel- Round Hubless Full Dot Fr Silicone Channel- Round Hubless Full N mm Silicone Channel Flat /4 Dot mm Silicone Channel Flat Full Dot mm Silicone Channel Flat Full /6 in Dot mm Silicone Channel Flat /4 /6 in Dot Fr Silicone Channle-Round Hubless Full N

5 PRIMARY ADAPTER TO CONNECT If you connect to a PVC Evacuator, the slicone sleeve can be removed If you connect to a PVC Evacuator, the slicone sleeve can be removed g Adapter with Sleeve g Silicone Bulb Evacuator If you connect to a PVC Evacuator, the slicone sleeve can be removed g Adapter with Sleeve g Silicone Bulb Evacuator If you connect to a PVC Evacuator, the slicone sleeve can be removed If you connect to a PVC Evacuator, the slicone sleeve can be removed g White Adapter g Y Connector PVC Evacuator

6 Silicone s Following is detail information about what adapters come Part Number Size Material Shape Perforated/ Fluted Length Trocar Number of /2 in Silicone Round End 24.4 cm /8 in Silicone Round End 24.4 cm /6 in Silicone Round End 24.4 cm /4 in Silicone Round End 24.4 cm /8 in Silicone Round End 24.4 cm Y /6 in Silicone Round End 24.4 cm Y /4 in Silicone Round End 24.4 cm Y mm Silicone Flat Hubless /4 20 cm mm Silicone Flat Hubless Full 20 cm mm Silicone Flat Hubless Full 20 cm /8 in Silicone Double Round Mid 24.4 cm Y /6 in Silicone Double Round Mid 24.4 cm Y /4 in Silicone Double Round Mid 24.4 cm Y mm Silicone Flat Hubless /4 20 cm PVC s Following is detail information about what adapters come Part Number Size Material Shape Perforated/ Fluted Trocar Number of /8 in PVC Double Round Mid /4 PVC Double Round Mid /6 in PVC Double Round Mid /2 in PVC Double Round Mid Y /8 in PVC Double Round Mid Y /6 in PVC Double Round Mid Y /4 in PVC Double Round Mid Y 0

7 Where are the Used? g Blue Adapter g Y Connector (s) PVC Evacuator g Blue Adapter g Y Connector(s) PVC Evacuator Extra used if drain is cut g Blue Adapter g Y Connector(s) PVC Evacuator Extra are used if drain is cut g Blue Adapter g Y Connector(s) PVC Evacuator Extra are used if drain is cut Where are the Used? g Y Connector of PVC Evacuator (no adapter needed) g Y Connector of PVC Evacuator (no adapter needed) g Y Connector of PVC Evacuator (no adapter needed) g Y Connector of PVC Evacuator (no adapter needed) g Y Connector of PVC Evacuator (no adapter needed) g Y Connector of PVC Evacuator (no adapter needed) g Y Connector of PVC Evacuator (no adapter needed)

8 Silicone Bulb Evacuator Kits Part Number Size Material Shape Perforated/ Fluted Evacuator Included Trocar Number of mm Silicone Flat Hubless /4 Silicone Bulb 00cc mm Silicone Flat Hubless /4 Silicone Bulb 00cc mm Silicone Flat Hubless Full Silicone Bulb 00cc mm Silicone Flat Hubless Full Silicone Bulb 00cc mm Silicone Flat Hubless /4 Silicone Bulb 00cc Y mm Silicone Flat Hubless /4 Silicone Bulb 00cc Y mm Silicone Flat Hubless Full Silicone Bulb 00cc Y mm Silicone Flat Hubless Full Silicone Bulb 00cc Y /8 in Silicone Round End Silicone Bulb 00cc Y /6in Silicone Round End Silicone Bulb 00cc Y 2 Reliavac Bulb Evacuator Kits (PVC) Part Number Size Material Shape Perforated/ Fluted Evacuator Included Trocar Number of /8 in Silicone Round End Reliavac Bulb 00cc Y /6 in Silicone Round End Reliavac Bulb 00cc Y mm Silicone Flat Hubless /4 Reliavac Bulb 00cc mm Silicone Flat Hubless /4 Reliavac Bulb 00cc mm Silicone Flat Hubless Full Reliavac Bulb 00cc mm Silicone Flat Hubless Full Reliavac Bulb 00cc mm Silicone Flat Hubless /4 Reliavac Bulb 00cc mm Silicone Flat Hubless /4 Reliavac Bulb 00cc mm Silicone Flat Hubless Full Reliavac Bulb 00cc mm Silicone Flat Hubless Full Reliavac Bulb 00cc

9 Following is detail information about what adapters come Where are the Used? 2 2 g Blue Adapter g Y Connector(s) PVC Evacuator g Blue Adapter g Y Connector (s) PVC Evacuator Following is detail information about what adapters come Where are the Used? 2 Extra Adapter- Extra Adapter for 2 nd Arm of Y Connector Extra for 2 nd Arm of Y Connector Extra for 2 nd Arm of Y Connector Extra for 2 nd Arm of Y Connector Extra for 2 nd Arm of Y Connector Extra for 2 nd Arm of Y Connector Extra for 2 nd Arm of Y Connector Extra for 2 nd Arm of Y Connector Extra for 2 nd Arm of Y-Connector

10 Reliavac Bottle Evacuator Kits (PVC) Part Number Size Material Shape Perforated/ Fluted Evacuator Included Trocar Number of /2 in PVC Round Mid Reliavac 400cc Y /8 in PVC Round Mid Reliavac 400cc Y /4 in PVC Round Mid Reliavac 400cc Y /6 in PVC Round End Reliavac 400cc Y /8 in Silicone Round End Reliavac 400cc Y /6 in Silicone Round End Reliavac 400cc Y /4 in Silicone Round End Reliavac 400cc Y 5 Three Spring Evacuator Kits (PVC) Part Number Size Material Shape Perforated/ Fluted Evacuator Included Trocar Number of /2 PVC Round Mid -Spring Y /8 in PVC Round Mid -Spring Y /4 in PVC Round End -Spring Y /6 in PVC Round End -Spring Y /8 Silicone Round -Spring Y /4 Silicone Round -Spring Y 2

11 Following is detail information about what adapters come Where are the Used? g Y Connector (no adapter needed) g Y Connector (no adapter needed) g Y Connector (no adapter needed) g Y Connector (no adapter needed) g Blue Adapter with Sleeve g Silicone Bulb Evactuator Following is detail information about what adapters come Where are the Used? g Pre-cut Y Connector (no adapter needed) g Pre-cut Y Connector (no adapter needed) g Pre-cut Y Connector (no adapter needed) g Pre-cut Y Connector (no adapter needed) 2 2

12 Summary Silicone s to Silicone Evacuators Use the adapter with the silicone sleeve to connect it to the silicone bulb If no adapter with a silicone sleeve is included in the package, attach the drain directly to the silicone bulb Silicone s to PVC Evacuators Use the blue adapter that has no sleeve to connect to PVC type evacuators such as the Three spring evacuator/reliavac bulb and Reliavac Bottle evacuators PVC s to Silicone Evacuators Not recommended PVC s to PVC Evacuators For Three Spring Evacuators, attach the drain directly to the Y connector. No adapter is required For the Reliavac family of evacuators, an adapter is normally needed unless it is a customized kit. INDICATIONS: Wound drains are used to remove exudates from wound sites. WARNINGS: An effective closed suction drain system requires maintenance of the system to preserve patency. The drain must not be allowed to occlude nor the reservoir to completely fill; and reservoir suction must be maintained in order for the system to function properly. Verify that the system is functioning properly. If the system is not maintained properly, surgical complications, including hematomas, may result. In the event of occlusion of the drain, all wound drainage via the drain ceases. Careful attention to the drain will minimize the possibility of this problem. If occlusion does occur, the drain can be aspirated by connecting suction to the reservoir outlet or temporarily disconnecting the drain from the reservoir and applying suction directly to the drain. If an air-tight seal between the drain and the skin where the drain emerges is not achieved, the air leak must be rectified or the system must be converted to open drainage. An airtight seal between all system components (drain, adaptor and reservoir) is necessary for proper system function. Leaving the soft silicone elastomer drain implanted for any period of time so as to cause tissue in growth around the drain can interfere with easy removal and may effect the performance of the drain. The surgeon should monitor the patient s rate of wound healing. Evacuators should be used in cardio-thoracic surgery only after the lung is fully expanded and all air leaks have sealed. perforations or channels must lie within the wound or cavity to be drained, otherwise inadequate drainage may result. To avoid the possibility of drain damage or breakage: o Avoid suturing through drains. o s should lie flat and in line with the skin exit areas. o Particular care should be taken to avoid any obstacles to the drain exit path. o s should be checked for free motion during closure to minimize the possibility of breakage. o removal should be done gently by hand. s should not be handled with pointed, toothed or sharp instruments which could cause cuts or nicks and lead to subsequent structural failure of the drain. o Surgical removal may be necessary if drain is difficult to remove or breaks. COMPLICATIONS Complications which may result from the use of this suction drainage system include the risks associated with methods utilized in the surgical procedure, as well as the patients degree of intolerance to any foreign object in the body. The advantages of wound drainage, particularly closed system drainage, are lost if an air-tight seal between the drain and the skin where the drain emerges is not achieved, or if the drain is allowed to become occluded or if the reservoir is not activated properly, doesn t function properly or is not monitored. Evacuators should be emptied and re-activated when required per hospital protocol. In the event an air-tight seal is not achieved, the reservoir will rapidly fill with air from the leak; subsequent drainage to the reservoir will occur only if allowed by gravity and wound exudate forcing the flow. Entry into the reservoir is allowed only by displacement of air in the reservoir by wound exudate flow. In this displacement process, air reflux from the reservoir to the wound can occur and increase the likelihood of back-contamination across the anti-reflux valve. In the event of drain occlusion by fibrin, clots, or other particulate matter, all wound drainage via the drain ceases. If the reservoir is not emptied when it is full, equilibrium between the drain and reservoir at wound pressure will ultimately occur and drainage from the wound site will cease. When the reservoir and drain are at the same pressure and the reservoir is full of fluid, the likelihood of back-contamination across the anti-reflux valve is increased. When used to drain the pleural cavity in the presence of an air leak, drains must be attached to an appropriate pleural cavity drainage system to prevent tension pneumothorax. CAUTION: Federal (U.S.A.) law restricts this device to sale by or on the order of a physician. For additional information contact your local Bard representative or call C. R. Bard, Inc. Covington, GA Bard, Advancing Lives and the Delivery of Healhtcare and Reliavac are trademarks and/or registered trademarks of C. R. Bard, Inc. 207 C. R. Bard, Inc. All Rights Reserved. Printed in U.S.A BMD/WDDR/06/004