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LETTER TO EDITOR |
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Year : 2014 | Volume
: 6
| Issue : 1 | Page : 43-44 |
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A practical tip to prevent intraoperative blockage of suction tubing
Usama Ahmed1, Firas Al Aswad2
1 Department of Trauma Surgery, The Royal London Hospital, Whitechapel, London, United Kingdom 2 Department of Plastic Surgery, Lister Hospital, Stevenage, United Kingdom
Date of Web Publication | 24-Jun-2014 |
Correspondence Address: Usama Ahmed Department of Trauma Surgery, The Royal London Hospital, Whitechapel, London United Kingdom
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DOI: 10.4103/2006-8808.135165
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How to cite this article: Ahmed U, Al Aswad F. A practical tip to prevent intraoperative blockage of suction tubing. J Surg Tech Case Report 2014;6:43-4 |
How to cite this URL: Ahmed U, Al Aswad F. A practical tip to prevent intraoperative blockage of suction tubing. J Surg Tech Case Report [serial online] 2014 [cited 2016 May 10];6:43-4. Available from: http://www.jstcr.org/text.asp?2014/6/1/43/135165 |
Sir,
Suction devices are routinely used during operative procedures to evacuate liquids such as blood and solutions used to irrigate wounds and cavities. These devices generate negative pressure (below standard atmospheric pressure) to achieve suction of fluids.
Direct application of suction tubing to tissues can cause soft tissue trauma and the tubing itself can also become blocked by soft-tissue debris thereby increasing surgical time.
In our practice, we have encountered this during cases requiring high volume washout such as debridement and washout of infected wounds where curettage of the wound bed creates a lot of soft tissue debris including globules of adipose tissue. This is also relevant in any intra-cavity procedures where minimal handling of and trauma to friable tissues such as bowel is desired.
To prevent blockage of the suction tubing, we use a simple, economical and effective method that allows us to aspirate fluid from the cavity whilst minimizing the soft tissue damage and preventing the blockage of the suction catheter. When aspirating a large volume of fluid, firstly remove smaller caliber attachments from the suction tubing such as Yankauer suckers. Hold in place a small swab over the suction tubing whilst aspirating the fluid [Figure 1]. This allows the fluid to be aspirated from cavities and protects the surrounding soft tissues [Figure 2]. A similar technique has also been described for laparoscopic procedures. [1] The advantage of this technique is that in addition to aspirating fluids, debris such as clots or other pieces of soft issue collect in the gauze and can easily be removed from the surgical field.![](/ServeContent?url=http%3A%2F%2Fwww.jstcr.org%2Farticles%2F2014%2F6%2F1%2Fimages%2FJSurgTechCaseReport_2014_6_1_43_135165_u1.jpg) | Figure 1: Remove any suction attachments e.g. Yankauer sucker and place a swab over the suction tubing
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![](/ServeContent?url=http%3A%2F%2Fwww.jstcr.org%2Farticles%2F2014%2F6%2F1%2Fimages%2FJSurgTechCaseReport_2014_6_1_43_135165_u2.jpg) | Figure 2: Technique being used during washout and debridement of necrotising fasciitis
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Techniques that flush the suction lumen to clear blockages have also been described. Badran and Karkos describe the use of a three-way tap attached to their suction device that flushes the sucker during otological microsurgery. Wissler and Morrissey presented a similar component for use in endoscopy. Similarly, Evans and colleagues described a newly designed microsuction-irrigation attachment that could be used during microsurgical vessel anastomoses to flush the vessel lumen with heparinised saline and also suction the area to keep a clear field of view when operating under the microscope. [2],[3],[4]
In conclusion, our method of applying a swab over the end of suction tubing during operative procedures is a simple yet inexpensive method of avoiding blockage of the tubing and removing the soft tissue debris from the surgical field and is a tip we think will be beneficial for junior and senior surgeons alike.
References | | ![Top](/ServeContent?url=http%3A%2F%2Fwww.jstcr.org%2Fimages%2Farrow_top.gif) |
1. | Balamoun H, Doughan S, Akhtar M. A simple technique to avoid blockage of the suction system in laparoscopic procedures. Ann R Coll Surg Engl 2011;93:326. ![Back to cited text no. 1](/ServeContent?url=http%3A%2F%2Fwww.jstcr.org%2Fimages%2Fref_top.gif) |
2. | Badran K, Karkos P. Recurrent blockage of the sucker during otological surgery: A simple solution. J Laryngol Otol 2007;121:266-7. ![Back to cited text no. 2](/ServeContent?url=http%3A%2F%2Fwww.jstcr.org%2Fimages%2Fref_top.gif) |
3. | Wissler DW, Morrissey JF. Use of an external suction-irrigation device in endoscopy. Gastrointest Endosc 1980;26:11-2. ![Back to cited text no. 3](/ServeContent?url=http%3A%2F%2Fwww.jstcr.org%2Fimages%2Fref_top.gif) [PUBMED] |
4. | Evans DM, Weightman B, Deane G. A new suction-irrigation device: Uses in microsurgery and plastic surgery. Br JPlast Surg 1983;36:273-7. ![Back to cited text no. 4](/ServeContent?url=http%3A%2F%2Fwww.jstcr.org%2Fimages%2Fref_top.gif) |
[Figure 1], [Figure 2]
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