| Popis: |
S urgical drains are occasionally used in cutaneous operation. They are most useful in areas where postsurgical defects may have a significant dead space such as the head and neck, and in patients with persistent bleeding to prevent hematoma formation.1,2 Closed suction drains are useful beneath large skin flaps. They improve apposition of tissue surfaces, thereby promoting adherence and healing. They also lower the risk of retrograde infection when compared with open, passive drains by preventing the stasis of blood.3-5 Ideally, drains should perform 4 functions: evacuate fluid; avoid damage to the surrounding tissue; decrease the risk of infection; and be easily removed when no longer needed.3 We demonstrate the unique use of the Vacutainer (Becton Dickinson and Company) as a closed, suction drain that facilitated all of these functions after excision of acne keloidalis nuchae. Excision of acne keloidalis nuchae produces a large, deep defect in a dependent area at the base of the neck; accordingly there is potential for fluid collection. The 10-mL red-topped Vacutainer is capable of producing 75 mm Hg of negative pressure. We used this negative pressure to develop a closed, compact suction drain by attaching the 10-mL redtopped Vacutainer to a 19-gauge winged infusion set (Surflo) placed at the base of the wound after excision of acne keloidalis nuchae. Several fenestrations were made in a circumferential fashion in the tubing approximately 1 cm apart as demonstrated in Fig 1. The metal connecting portions were then cut off, and the tubing placed on the floor of the wound of the posterior neck and sutured to the lateral edges of the incision. The tubing could be lengthened or shortened as needed to accommodate wound size. The wound was closed and the needles of the infusion set were inserted through the rubber stoppers of the Vacutainer tubes located on both sides of the wound (Fig 2). Each 10-mL Vacutainer is able to provide 75 mm Hg of negative pressure forming a compact, closed, active suction drain (Fig 3). These were left in place for 2 days and a total of 13 mL of serosanguinous fluid was drained into the VacuFrom the Department of Dermatology, St Louis University. Funding sources: None. Conflict of interest: None identified. Reprint requests: Anne T. Riordan, MD, Department of Dermatology, St Louis University, 1755 S Grand Ave, St Louis, MO 63104. J Am Acad Dermatol 2003;48:933-4. Copyright © 2003 by the American Academy of Dermatology, Inc. 0190-9622/2003/$30.00 0 doi:10.1067/mjd.2003.70 Fig 1. Demonstration of ports being placed in tubing. |
Full Text from ScienceDirect