Usefulness of High Pressure Aspiration with Overcoated Double Luminal Draining Tube to Prevent of Abdominal Sepsis (Abscess and Anastomotic Leakage)

Yoshihiro Moriwaki, Kenichi Yoshida, Goro Matsuda, Satoshi Hasegawa, Toshiro Yamamoto and Mitsugi Sugiyama

Department of Critical Care and Emergency Medicine, Yokohama City University, School of Medicine, Yokohama Citizen Medical Center Hospital

Introduction: Intestinal content or purulent fluid continuously produced in the abdominal cavity must be aspirated to prevent abdominal sepsis. We discuss the usefulness of high pressure aspiration system (HPA) using overcoated double luminal draining tube.
1. Clinical investigation Methods: Fluid adhesion to gauze, discharge from the drain during lavage, and skin around the drain were compared in 14 subjects before and after HPA. The overcoated double luminal draining tube consisted of an outer and inner tubes. The end of the inner tube was 5 mm behind that of the outer tube and aspirated at the highest central vacuum pressure system, such as in suction used in surgery. Results: Fluid adhesion to gauze, discharge from the drain during lavage, and skin around the drain improved after HPA (P<0.0001), with 173.3 g of fluid aspirated a day and dressing changes decreased from 7.1 to 2.7 a day (P<0. 0001).
2. Experimental investigation Methods: Mucinous fluid in an irregularly hollowed sponge abscess model was continuously aspirated with a HPA model and low pressure with a sump tube. The ratio of residual to initial volume (aspiration ratio) and final residual volume (final aspiration rate) were studied. Results: Both the aspiration ratio and final aspiration rate were low in the high pressure model (P<0.0001, P<0.0001). Discussion and Conclusion: HPA is useful in removing intestinal and purulent fluid. Care must be taken, however, to avoid aspirating tissue due to dislocation of the end of inner tube and blockage due to the adhesion of dried matters making it important to change the inner tube as soon as convenient.

Key words
double luminal draining tube with high pressure aspiration, privention of abdominal sepsis, abcess model for experimental study, evaluation of draining system

Reprint requests
Yoshihiro Moriwaki Department of Critical Care and Emergency Medicine, Yokohama City University, School of Medicine, Yokohama Citizen Medical Center Hospital 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024 JAPAN

Accepted
February 27, 2002

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