Dead space and drainage Flashcards Preview

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Flashcards in Dead space and drainage Deck (33):
1

What is dead space?

a space formed between tissues that are normally anatomically connected

2

What do dead spaces most commonly fill with?

fluid, sometimes gas

3

What causes dead space?

excessive dissection during surgery or trauma--separation of tissues

4

What is the classic case of trauma that causes dead space?

big dog picks up little dog by scruff and shakes

5

What can create dead space during surgery?

1. poor technique #1
2. mass removal
3. reconstruction

6

What is a seroma?

collection of serum in a tumor like mass

7

Why do we want to avoid dead space?

1. slows healing (can't get fibrin bridge; blood supply compromised)
2. increases risk of infection of the wound--(rich nutrients in seroma)

8

How do you minimize dead sapce?

1. meticulous minimalist technique
2. mayo disseciton
3. remove only target tissue

9

How do you manage dead sapce?

1. layered wound closure
2. tacking sutures
3. compression bandage
4. drainage

10

Where should you use surgical drainage?

where there is significant dead space or where expect fluid to accumulation cand cause a problem

11

Where should you not use drainage?

where the wound shouln't be closed around a drain
1. contamination
2. more debridement required

12

Why is it pointless to sitck a drain in an abscess of guinea pigs, rabbits or birds?

their pus is too viscous

13

How do passive drains work?

they use capillary action, gravity and/or pressure gradients to remove fluid

14

What is a penrose drain?

the most commonly used passive drain in vet med

15

How do passive drains work?

they use capillary action, gravity and/or pressure gradients to remove fluid. the entire tubing acts as a slide.

16

What is a penrose drain?

the most commonly used passive drain in vet med

17

How do you use a penrose drain?

1. rinse with sterile saline to remove powder
2. have a ventral exit that is NOT part of the incision or wound
3. cover!!!
4. tack in place with a suture or two at exit site
5. make sure exit wound is large enough that it will stay open ntil next bandage change
6. don't lose it in the wound

18

how do active drains work?

they use suction to remove fluid

19

Why do active drains need to have a closed system?

because suction needs to be generated

20

What is a "rocket pack"?

An active drain made with a butterfly catheter and red rubber tubes or a syrynge with a plunger fixed in place

21

Which should be fenestrated, active or passive tubes?

active NOT passive

22

What is a ready made active drain?

Jackson Pratt

23

How is the active drain fixed to the skin?

finger trap pattern

24

Why does the collection system of an active drain need to be emptied using sterile technique?

because any contamination of the collection system means that bacteria will gain entry and crawl up the tubing into the wound

25

What is compression directly and inversely correlated to?

1. direct: tension, layers
2. width, radius of limb

26

What can cause blockage of a drain?

dibrin

27

What can cause blockage of a drain?

fibrin

28

When shoudl drains be removed?

when the quantity of fluid retrieved has decreased and leveled off and the quality of the fluid is clear (

29

What are three specialized drainage techniques?

1. omentization
2. open wound drainage
3. vacuum assisted closure

30

What is omentization?

use the omentum as a natural drain and place in abscessed cavities

31

What is open wound drainage?

open wound that is protected. most effective removal of fluid COVER

32

What is vacuum assisted closure?

a vacuum set to a specific pressure (125mmHG) is applied to a wound and stimulates angiogenesis and granulation tissue. also rapidly reduces load of microoragnisms. Controls dead space with vacoom action and encourages tissue adherence.

open cell foam is packed into the wound and tubing placed through foam to the vaccume source. occlusive dressing is over everything

33

Where is vacuum assisted closure contraindicated?

1. tumor bed/malignancy
2. exposed blood vessels/organs
3. necrotic tissue
4. active bleeding
5. patients treated with anticoagulant