Final suture placed, dressings in place, patient can be extubated. It would seem that at this moment the surgeon can calmly exhale: the operation was successful. But the completion of an operative intervention in surgery is only half of the work done necessary to achieve the desired result. In the postoperative period, unforeseen situations and complications may arise, which to a large extent can affect the result of the operation itself. One of the important elements of physical antisepsis, necessary for a favorable course of the postoperative period, is wound drainage. On estet-portal.com read about the types of drainage and its need for plastic surgery.
Peculiarities of wound drainage in plastic surgery
At first glance, it may seem that wound drainage is only necessary if there is a high risk of developing an inflammatory process, but this is not entirely true. Drainage is a way of removing liquid content from a wound, which can be exudate or transudate.
If exudate is a fluid released during inflammation, then transudate is an edematous fluid that accumulates as a result of impaired blood and lymph circulation.
As you know, edema is one of the characteristic and fairly frequent early complications of plastic surgery, and in some cases, wound drainage is an effective and necessary method to ensure the outflow of fluid accumulated in the wound.
Wound drainage:
• what effects should wound drainage provide;
• passive wound drainage after plastic surgery;
• active wound drainage after plastic surgery.
What effects should wound drainage provide
Wound drainage plays an important role in creating favorable conditions for the course of the wound healing process. Drainage is not always carried out, and the decision on the need for this procedure is made by the operating surgeon himself. Wound drainage should provide:
• prevention of the development of an infectious process by removing an excess amount of wound contents from the wound;
• active wound cleansing;
• tight contact of wound surfaces, which helps to stop bleeding from small vessels.
Passive wound drainage after plastic surgery
There are two main types of wound drainage: active and passive. Passive drainage involves the removal of wound contents through the line of skin sutures. Passive drainage ensures the removal of fluid only from the superficial sections of the wound. Drainages are installed through inter-sutural spaces, mainly interrupted skin sutures. Passive wound drainage is notable for its simplicity, but at the same time, this method of removing fluid from the wound has little efficiency. Such drainages are used for superficial wounds located in those areas where the quality of the suture may be reduced.
Active wound drainage after plastic surgery
Active drainage is the main type of drainage for complex wounds. Such drainage involves sealing the skin wound and the presence of special devices and tools necessary for the drainage tubes. Active drainage is distinguished by its high efficiency and the possibility of floor drainage of the wound. It is best to choose the exit points for drainage tubes in "hidden" areas - on the scalp, in the armpits, in the pubic area, and so on. Such drains are usually removed 1-2 days after surgery, when the volume of the separated fluid does not exceed 40 ml.
Drainage of a wound in plastic surgery is one of the methods of preventing the inflammatory process, but it is important to remember that the decision on the need for drainage should be made by the surgeon individually for each operated patient.
The choice of drainage method depends on the location, size and individual characteristics of the wound, and failure to drain can lead to the accumulation of a significant amount of wound contents in the wound and subsequent purulent complications.
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