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Kim KR, Shim KN, Choe AR, Lee MJ, Park YH, Song EM, Tae CH, Jung SA. A Case of Intramural Gastric Wall Abscess, a Rare Disease Successfully Treated with Endoscopic Incision and Drainage. Gut Liver 2023; 17:949-953. [PMID: 36700301 PMCID: PMC10651380 DOI: 10.5009/gnl220009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/27/2022] [Accepted: 06/10/2022] [Indexed: 01/27/2023] Open
Abstract
Gastric wall abscess is a rare condition characterized by a purulent inflammatory process resulting in the formation of a pocket of pus in the stomach. As the mucosa is usually intact, it requires various tools such as endoscopic ultrasonography or computed tomography for the differential diagnosis to rule out more common subepithelial tumors. Even after the diagnosis, the treatment for gastric wall abscess was previously restricted to surgical resection in combination with antibiotics. Currently, in order to avoid unnecessary surgery, the alternative method of initial treatment with an endoscopic approach is recommended. It also helps to choose appropriate antibiotics with confirmation of the pathogen by drainage. There are few reports that describe the detailed processing of the endoscopic drainage, and there is no consensus on the treatment. The pathogens that cause gastric wall abscess are usually Streptococci, Staphylococci, and Escherichia coli. There is only one case reported to be caused by Candida albicans. This is the first report of Elizabethkingia anopheles as the pathogen of the gastric wall abscess. Here, we report a case of gastric wall abscess in a 75-year-old man, safely treated by endoscopic drainage and antibiotics, confirmed by isolating the contents of the abscess.
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Affiliation(s)
- Kyung Rok Kim
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Ki Nam Shim
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - A Reum Choe
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Min Jong Lee
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Ye Hyun Park
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Eun Mi Song
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Chung Hyun Tae
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Sung Ae Jung
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
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Stelmar J, Smith SM, Chen A, Masterson JM, Hu V, Garcia MM. Procedures Never Explained in Textbooks: How to Correctly Convert a Closed-Suction Drain to a Closed-Gravity Drain, and How to Correctly Remove a Closed-Suction Drain Off Suction. J Surg Res (Houst) 2022; 5:419-422. [PMID: 36285252 PMCID: PMC9592071 DOI: 10.26502/jsr.10020236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To describe a novel method to convert a closed-system suction drain to a highly efficient closed-system gravity-dependent drain and demonstrate its efficacy in an ex-vivo model. METHODS We reviewed the 5 top-selling urology and surgery text/reference books for information on drainage systems. An ex-vivo model was designed with a reservoir of fluid connected to a Jackson-Pratt bulb drain. We measured the volume of fluid drained from the reservoir into the bulb while on-suction and off-suction. This was repeated using a novel modified bulb, where the bulb's outflow stopper was replaced with a one-way valve oriented to allow release of pressure from the bulb. RESULTS With the bulb on-suction, drainage was maintained regardless of the height of the drain relative to the reservoir. With the bulb off-suction, closed passive gravity-dependent drainage occurred only when the drain was below the fluid reservoir; drainage ceased at minimal volumes. With addition of a one-way valve and maintenance of the bulb below the level of the reservoir, drainage proceeded to completion. CONCLUSION How surgical drains work is not described in the leading urology and general surgery textbooks/reference books. Closed-system suction drains cannot be used to achieve passive gravity-dependent drainage without allowing release of displaced air from the bulb-lumen. The novel modified drain we describe affords reversible closed-system suction and passive drainage.
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Affiliation(s)
- Jenna Stelmar
- Cedars-Sinai Medical Center, Los Angeles, Division of Urology; Los Angeles, CA
- Cedars-Sinai Transgender Surgery and Health Program; Los Angeles, CA
| | - Shannon M Smith
- Cedars-Sinai Medical Center, Los Angeles, Division of Urology; Los Angeles, CA
- Cedars-Sinai Transgender Surgery and Health Program; Los Angeles, CA
| | - Andrew Chen
- Cedars-Sinai Medical Center, Los Angeles, Division of Urology; Los Angeles, CA
| | - John M Masterson
- Cedars-Sinai Medical Center, Los Angeles, Division of Urology; Los Angeles, CA
| | - Vivian Hu
- University of California Los Angeles, School of Medicine; Los Angeles, CA
| | - Maurice M Garcia
- Cedars-Sinai Medical Center, Los Angeles, Division of Urology; Los Angeles, CA
- Cedars-Sinai Transgender Surgery and Health Program; Los Angeles, CA
- University of California San Francisco; Department of Urology and Department of Anatomy; San Francisco, CA
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Manta N, Mangiavini L, Balbino C, Colombo A, Pandini EG, Pironti P, Viganò M, D'Anchise R. The role of suction drainage in the management of peri-operative bleeding in Total and Unicomcompartmental knee arthroplasty: a retrospective comparative study. BMC Musculoskelet Disord 2021; 22:1031. [PMID: 34893042 PMCID: PMC8665489 DOI: 10.1186/s12891-021-04868-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 11/15/2021] [Indexed: 11/10/2022] Open
Abstract
Background Suction drainage is commonly applied after total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) to reduce hematoma, swelling and to favor surgical wound healing. However, its efficacy remains controversial; thus, the purpose of this study is to evaluate drainage efficiency in the management of postoperative bleeding in TKA and UKA. Methods The cohort comprised 134 clinical records of patients affected by knee osteoarthritis (OA) who underwent either TKA or UKA. All the patients were subdivided into 2 groups: the first one with drainage and the second one without drainage (respectively 61 and 73 patients). For each group, hemoglobin levels in the preoperative, first, second and third postoperative day were collected. Postoperative complications such as swelling, bleeding from the surgical wound or the need for blood transfusion, were also recorded. Results Our results did not show any significant difference of hemoglobin levels in the first (p = 0.715), second (p = 0.203) and third post-operative day (p = 0.467) between the two groups. Moreover, no significant correlation between knee swelling or transfusion rate and the drainage was observed (p = 0.703 and p = 0.662 respectively). Besides, a significant correlation was found between bleeding from the surgical wound and the absence of drainage (p = 0.006). Conclusions The study demonstrates how the routine use of suction drainage does not provide substantial benefits in the postoperative blood loss management after TKA or UKA. Trial registration ClinicalTrials.gov NCT04508101, 09/08/2020, Retrospectively registered Level of evidence III
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Affiliation(s)
- Nicola Manta
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Laura Mangiavini
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. .,Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
| | | | - Andrea Colombo
- Residency Program in Orthopedics and Traumatology, University of Milan, Milan, Italy
| | | | - Pierluigi Pironti
- Residency Program in Orthopedics and Traumatology, University of Milan, Milan, Italy
| | - Marco Viganò
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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Bartosz P, Marczyński W, Para M, Kogut M, Białecki J. Comparative study of suction drainage placement in cementless hip replacement among patients undergoing extended thromboprophylaxis: a prospective randomized study. BMC Musculoskelet Disord 2021; 22:688. [PMID: 34389016 PMCID: PMC8364014 DOI: 10.1186/s12891-021-04583-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 08/04/2021] [Indexed: 11/25/2022] Open
Abstract
Background The use of drains reportedly does not improve surgical outcomes after hip replacement. There is still a lack of strict recommendations for drain placement after primary hip replacement. This study aimed to assess the safety of not using suction drainage after primary hip replacement in a population of patients undergoing extended thromboprophylaxis. Methods In this prospective randomized study, all patients were qualified for primary hip replacement and were divided into two groups: with and without drainage. The inclusion criterion was idiopathic hip osteoarthritis. The exclusion criteria were secondary coxarthrosis, autoimmune disease, coagulopathy, venous/arterial thrombosis, hepatic/renal insufficiency, cement, or hybrid endoprostheses. We performed an intention-to-treat analysis. Clinical, laboratory, and radiographic parameters were measured for the first three days after surgery. Hematoma collection, due to extended thromboprophylaxis, in the joint and soft tissues was evaluated precisely. The patients underwent follow-up for 30 days. Results The final analysis included a total of 100 patients. We did not find any significant statistical differences between groups in terms of hip fluid collection (9.76 vs. 10.33 mm, with and without drainage, respectively; mean difference, 0.6 mm; 95 % confidence interval [CI] -2.8 to 3.9; p = 0.653), estimated blood loss (1126 vs. 1224 ml; mean difference, 97.1 ml; 95 % CI -84.1 to 278.2; p = 0.59), and hemoglobin levels on postoperative day 3 (11.05 vs. 10.85 g/dl; mean difference, 0.2; 95 % CI -2.1 to 2.5; p = 0.53). In addition, the other parameters did not show significant differences between groups. Notably, two cases of early infections were observed in the no-drainage group, whereas there were no such complications in the drainage group. Conclusions We conclude that the use of closed suction drainage after primary hip replacement is a safe procedure in patients undergoing extended thromboprophylaxis. Further research is warranted to validate these findings. Trial registration The study was successfully registered retrospectively at Clinicaltrial.gov with the identification number NCT04333264 03 April 2020.
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Affiliation(s)
- Paweł Bartosz
- Orthopedic Department, Centre of Postgraduate Medical Education, Konarskiego 13, Kosciuszki 3/10B, 05-400, Otwock, Poland.
| | - Wojciech Marczyński
- Orthopedic Department, Centre of Postgraduate Medical Education, Konarskiego 13, Kosciuszki 3/10B, 05-400, Otwock, Poland
| | - Marcin Para
- Orthopedic Department, Centre of Postgraduate Medical Education, Konarskiego 13, Kosciuszki 3/10B, 05-400, Otwock, Poland
| | - Maciej Kogut
- Orthopedic Department, Centre of Postgraduate Medical Education, Konarskiego 13, Kosciuszki 3/10B, 05-400, Otwock, Poland
| | - Jerzy Białecki
- Orthopedic Department, Centre of Postgraduate Medical Education, Konarskiego 13, Kosciuszki 3/10B, 05-400, Otwock, Poland
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Li X, Paz-Fumagalli R, Wang W, Toskich BB, Stauffer JA, Frey GT, McKinney JM, Nguyen JH. Percutaneous direct pancreatic duct intervention in management of pancreatic fistulas: a primary treatment or temporizing therapy to prepare for elective surgery. BMC Gastroenterol 2021; 21:44. [PMID: 33509111 PMCID: PMC7844943 DOI: 10.1186/s12876-021-01620-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 01/18/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND This study evaluates preliminary results of image-guided percutaneous direct pancreatic duct intervention in the management of pancreatic fistula after surgery or pancreatitis when initially ineligible for surgical or endoscopic therapy. METHODS Between 2001 and 2018 the medical records of all patients that underwent percutaneous pancreatic duct intervention for radiographically confirmed pancreatic fistula initially ineligible for surgical or endoscopic repair were reviewed for demographics, clinical history, procedure details, adverse events, procedure related imaging and laboratory results, ability to directly catheterized the main pancreatic duct, and whether desired clinical objectives were met. RESULTS In 10 of 11patients (6 male and 5 female with mean age 60.5, range 39-89) percutaneous pancreatic duct cannulation was possible. The 10 duct interventions included direct ductal suction drainage in 7, percutaneous duct closure in 3 and stent placement in 1. Pancreatic fistulas closed in 7 of 10, 2 were temporized until elective surgery, and 1 palliated until death from malignancy. The single patient with failed duct cannulation resolved the fistula with prolonged catheter drainage of the peri-pancreatic cavity. There were no major adverse events related to intervention. CONCLUSION In patients with pancreatic fistulas initially ineligible for endoscopic therapy or elective surgery, direct percutaneous pancreatic duct interventions are possible, can achieve improvement without major morbidity or mortality, and can improve and maintain the medical condition of patients in preparation for definitive surgery.
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Affiliation(s)
- Xi Li
- Interventional Radiology Department, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guandong, China.,Division of Interventional Radiology, Mayo Clinic, Jacksonville, FL, 32224, USA
| | | | - Weiping Wang
- Division of Interventional Radiology, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Beau B Toskich
- Division of Interventional Radiology, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - John A Stauffer
- Department of General Surgery, Mayo Clinic, Jacksonville, FL, USA
| | - Gregory T Frey
- Division of Interventional Radiology, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - J Mark McKinney
- Division of Interventional Radiology, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Justin H Nguyen
- Department of Transplantation, Mayo Clinic, Jacksonville, FL, USA
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Li X, Li J, Sui J, Niyazi T, Yalikun N, Wang S. Advantages of using a prophylactic epidural closed drain and non-watertight dura suture in a craniotomy near the "parietal site". Chin Neurosurg J 2020; 6:34. [PMID: 33029384 PMCID: PMC7534153 DOI: 10.1186/s41016-020-00212-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 08/27/2020] [Indexed: 11/10/2022] Open
Abstract
Background In neurosurgery, the necessity of having a drainage tube is controversial. Subgaleal fluid collection (SFC) often occurs, especially in a craniotomy near the "parietal site".This study aimed to reassess the benefit of using a prophylactic epidural drainage (ED) and non-watertight dura suture in a craniotomy near the parietal site. Methods A retrospective review was conducted on 63 consecutive patients who underwent a craniotomy near the parietal site. The patients were divided into two groups according to different period. The deal group received ED and a non-watertight dura suture (drain group, DG), the control group that did not (non-drain group, NDG). Complications and patient recovery were evaluated and analysed. Results Three patients (11.5%, 26) in DG and 20 patients (54.1%, 37) in NDG presented with SFC (p < 0.05). One patient (3.8%) in DG and three patients (8.1%) in NDG presented with subdural tensile hydrops (STH) (p > 0.05). Six developed an infection in NDG (four intracranial infections, one abscess, one pulmonary infection), while none in DG (p > 0.05) developed infection. Three (11.5%) cases in DG and one (2.7%) case in NDG had muscle strength that improved postoperatively (p > 0.05). Fifteen (57.7%) in DG and 14 (37.8%) in NDG had epileptic seizures less frequently postoperatively (p < 0.05). The average temperature (37.4 °C vs 37.6 °C, p > 0.05), the maximum temperature (37.9 °C vs 38.1 °C, p > 0.05) on 3 PODs, the postoperative hospital stay day (7.5 days vs 8.0 days, p > 0.05), and the postoperative medicine fee (¥29762.0 vs ¥28321.0, p > 0.05) were analysed. Conclusion In patients who undergo a craniotomy near the parietal site, the prophylactic use of ED and a non-watertight dura suture helps reduce SFC, infection, and control epilepsy.
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Affiliation(s)
- Xin Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070 China
| | - Jing Li
- Department of Operating Room, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070 China
| | - Jianfei Sui
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070 China
| | - Tuerdialimu Niyazi
- Depatment of Neurosurgery, Hetian District Hospital, No. 103 Wenhua Road, Hetian District, Hetian City, 848000 Xinjiang Uygur Autonomous Region China
| | - Naibijiang Yalikun
- Depatment of Neurosurgery, Hetian District Hospital, No. 103 Wenhua Road, Hetian District, Hetian City, 848000 Xinjiang Uygur Autonomous Region China
| | - Shuo Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South 4th Ring West Road, Fengtai District, Beijing, 100070 China
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Lee JS, Kim MK, Kang SH. Maxillary sinus haziness and facial swelling following suction drainage in the maxilla after orthognathic surgery. Maxillofac Plast Reconstr Surg 2020; 42:33. [PMID: 33024739 PMCID: PMC7509027 DOI: 10.1186/s40902-020-00277-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 09/13/2020] [Indexed: 11/30/2022] Open
Abstract
Background We investigated the efficacy of a maxillary Jackson-Pratt (J-P) suction drain for preventing maxillary sinus hematoma and facial swelling after maxillary Le Fort I osteotomy (LF1). Methods We retrospectively evaluated 66 patients who underwent LF1 at a single institution. Of these, 41 had a J-P suction tube inserted in the mandible and maxilla (maxillary insertion), and 25 had a J-P drain inserted in the mandible only (no maxillary insertion). Facial CT was obtained before and 4 days after surgery. We compared mean midfacial swelling and maxillary sinus haziness by t test and examined correlations between bleeding amount and body mass index (BMI). Results For the maxillary-insertion group, the ratio of total maxillary sinus volume to haziness (57.5 ± 24.2%) was significantly lower than in the group without maxillary drain insertion (65.5% ± 20.3; P = .043). This latter group, however, did not have a significantly greater midfacial soft tissue volume (7575 mm3) than the maxillary-insertion group (7250 mm3; P = .728). BMI did not correlate significantly with bleeding amount or facial swelling. Conclusions Suction drainage in the maxilla reduced maxillary sinus haziness after orthognathic surgery but did not significantly reduce midfacial swelling.
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Affiliation(s)
- Jung-Soo Lee
- Department of Oral and Maxillofacial Surgery, National Health Insurance Service Ilsan Hospital, 100 Ilsan-ro, Ilsan-donggu, Goyang, Gyeonggi-do 10444 Republic of Korea
| | - Moon-Key Kim
- Department of Oral and Maxillofacial Surgery, National Health Insurance Service Ilsan Hospital, 100 Ilsan-ro, Ilsan-donggu, Goyang, Gyeonggi-do 10444 Republic of Korea.,Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea
| | - Sang-Hoon Kang
- Department of Oral and Maxillofacial Surgery, National Health Insurance Service Ilsan Hospital, 100 Ilsan-ro, Ilsan-donggu, Goyang, Gyeonggi-do 10444 Republic of Korea.,Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea
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Ringeval N, Decrucq F, Weyrich P, Desrousseaux JF, Cordonnier D, Graf S, Perrin A. Diagnostic performance of suction drainage fluid culture for acute surgical site infection after aseptic instrumented spine surgery: a retrospective analysis of 363 cases. Eur J Orthop Surg Traumatol 2020; 31:155-160. [PMID: 32743683 DOI: 10.1007/s00590-020-02755-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 07/25/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Analyze the diagnostic performance of suction drainage fluid culture for acute surgical site infection, which has not been specifically reported in spine surgery patients. METHOD This was a retrospective single-center observational study including data from 363 patients who underwent aseptic instrumented spine surgery between 2015 and 2017. A suction drain was inserted in all cases. Data analyzed were patient age, gender, ASA score, indication for surgery (degenerative disease, tumor, trauma), spine level (cervical, thoracic, lumbar), procedure performed and spine level, operative time, body temperature, postoperative C-reactive protein time-curve, clinical aspect of surgical scar, bacteriology results of suction drainage fluid, and in case of revision surgery, lavage fluid. Major criteria for periprosthetic infection proposed by the Musculoskeletal Infection Society (MSIS) were accepted as the gold standard for the diagnosis of acute surgical site infection. RESULTS The overall rate of surgical site infection was 6.9% (5.76% for 1- or 2-level fusion, 5.81% for 3- or 4-level fusion, and 15.6% for 5-level fusion and above). The suction drain was withdrawn on the second postoperative day in 44.1% of cases and the third day in 39.1%. The sensitivity of suction drainage fluid culture for the diagnosis of surgical site infection was 20% [95%CI 6.8-40.7%] with a 96.2% [95%CI 93.2-97.9] specificity. CONCLUSION The diagnostic performance of suction drainage fluid culture after aseptic instrumented spine surgery for acute surgical site infection is insufficient to warrant its use in routine practice.
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Affiliation(s)
- Nathan Ringeval
- Trauma and Orthopedic Department, Saint Philibert Hospital Center-Lomme, Rue du Grand But-BP 249, 59462, Lomme Cedex, France.
| | - François Decrucq
- Trauma and Orthopedic Department, Saint Philibert Hospital Center-Lomme, Rue du Grand But-BP 249, 59462, Lomme Cedex, France
| | - Pierre Weyrich
- Transveral Infectious Disease Department, Saint Philibert Hospital Center-Lomme, Lomme, France
| | - Jean François Desrousseaux
- Trauma and Orthopedic Department, Saint Philibert Hospital Center-Lomme, Rue du Grand But-BP 249, 59462, Lomme Cedex, France
| | - Denis Cordonnier
- Trauma and Orthopedic Department, Saint Philibert Hospital Center-Lomme, Rue du Grand But-BP 249, 59462, Lomme Cedex, France
| | - Sahara Graf
- Biostatistics Department, Delegation for Clinical Research and Innovation, Lille Catholic University-Lille, Lille, France
| | - Alexis Perrin
- Trauma and Orthopedic Department, Saint Philibert Hospital Center-Lomme, Rue du Grand But-BP 249, 59462, Lomme Cedex, France
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Chen CY, Chiu YL, Rajbhandari S, Cheng SY, Lin HC, Chu YH, Lee JC. Predictive factors of increased surgical drain output after thyroid lobectomy: a retrospective study. Gland Surg 2019; 8:542-549. [PMID: 31741885 DOI: 10.21037/gs.2019.10.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background Thyroid lobectomy is one of the most common operations for thyroid lesions. Life-threatening complications can occur; these include post-operative bleeding with airway compression caused by hematoma. Given this risk, prophylactic drains are routinely used in our practice. The aim of this study was to identify factors that influence the total drainage volume (TDV). Methods From 2016 to 2017, a total of 89 consecutive patients with thyroid lobectomy performed by the same surgeon were included in the study. The demographic characteristics of the patients, TDV, fine needle aspiration cytology, hospitalization day, operation time, thyroid gland size, and blood test results were retrospectively recorded from the hospital database. Spearman's rank correlation and multivariate regression were used to analyze the association of factors with the TDV. Results The median TDV was 56 mL, and there was a positive correlation between age, weight, blood sugar, gland size, hospitalization day, operation time, and TDV. Multivariate regression analysis revealed that male sex (β=19.684; 95% CI, 7.998-31.371; P=0.001), higher blood sugar (β=0.173; 95% CI, 0.087-0.260; P<0.001), and larger thyroid gland size (β=0.069; 95% CI, 0.008-0.130; P=0.027) were independent risk factors for TDV. Conclusions The TDV primarily depends on male sex, larger thyroid gland, and higher blood sugar level. Patients with these factors should undergo meticulous hemostasis and bleeding should be carefully monitored in the perioperative period.
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Affiliation(s)
- Chih-Yu Chen
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei
| | - Yu-Lung Chiu
- School of Public Health, National Defense Medical Center, Taipei
| | - Sarina Rajbhandari
- Department of Otolaryngology-Head and Neck Surgery, Shankarapur Hospital, Kathmandu, Nepal
| | - Sheng-Yao Cheng
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei
| | - Hung-Che Lin
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei
| | - Yueng-Hsiang Chu
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei
| | - Jih-Chin Lee
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei
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Moon HS, Lee SK, Kim SR, Kim SJ. Cardiac arrest due to intracranial hypotension following pseudohypoxic brain swelling induced by negative suction drainage in a cranioplasty patient: a case report. Korean J Anesthesiol 2016; 69:292-5. [PMID: 27274378 PMCID: PMC4891545 DOI: 10.4097/kjae.2016.69.3.292] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 03/16/2015] [Accepted: 04/04/2015] [Indexed: 11/26/2022] Open
Abstract
Pseudohypoxic brain swelling (PHBS) is known to be an uncommon event that may occur during and following an uneventful brain surgery, when negative suction drainage is used. The cerebrospinal fluid loss related to suction drainage can evoke intracranial hypotension that progress to PHBS. The main presentations of PHBS are sudden unexpected circulatory collapses, such as severe bradycardia, hypotension, cardiac arrest, consciousness deterioration and diffuse brain swelling as seen with brain computerized tomography (CT). We present a stuporous 22-year-old patient who underwent cranioplasty under general anesthesia. The entire course of the general anesthesia and operation progressed favorably. However, the time of scalp suture completion, sudden bradycardia and hypotension occurred, followed by cardiac arrest immediately after initiation of subgaleal and epidural suction drainage. After successful resuscitation, the comatose patient was transferred to the neurosurgical intensive care unit and PHBS was confirmed using brain CT.
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Affiliation(s)
- Hyun-Soo Moon
- Department of Anesthesiology and Pain Medicine, Hallym University College of Medicine, Anyang, Korea
| | - Soo Kyung Lee
- Department of Anesthesiology and Pain Medicine, Hallym University College of Medicine, Anyang, Korea
| | - Su Ryun Kim
- Department of Anesthesiology and Pain Medicine, Hallym University College of Medicine, Anyang, Korea
| | - Seon Ju Kim
- Department of Anesthesiology and Pain Medicine, Hallym University College of Medicine, Anyang, Korea
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Temiz G, Yeşiloğlu N, Şirinoğlu H, Yalçin S, Sarici M, Bozkurt M. Continuous Suction Drainage of Postoperative Hematoma and Seroma Using Cystofix Device. Aesthetic Plast Surg 2015; 39:1026-7. [PMID: 26395093 DOI: 10.1007/s00266-015-0563-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 09/14/2015] [Indexed: 10/23/2022]
Abstract
UNLABELLED In this study, an easy and useful method used for the drainage of seroma and hematoma formations occurring after operations requiring extensive tissue undermining is presented. The method utilizes the trocar of the conventional suprapubic urinary catheterization system in combination with the catheter of the negative pressure vacuum drainage system. It provides quick, safe, and painless seroma and hematoma evacuation and can easily be performed in office setting. NO LEVEL ASSIGNED This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266.
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