(57) Abstract:The invention relates to medicine, namely to purulent surgery. The technical result of the invention is improving the efficiency of the sealed drainage of abscesses. The drainage consists of suction and multiple irrigation tube with side holes located in different planes relative to the longitudinal axis of the suction tube. One end of each of the irrigation tube is plugged and fixed to the working end of the suction tube, and the opposite is placed on its outer surface with the possibility of reciprocation and the formation of a loop variable area on its working end. Positional stability of the drainage system is achieved by shunting one or more loops formed irrigation tubes commensurate with them flexible core. 3 Il. The invention relates to medicine, namely to purulent surgery.Known drainage device containing the irrigation and suction tube with side holes, and the irrigation tube in the middle segment forms a loop before the working end of the suction tube, and its available capacity mutual reciprocating movement of the suction and irrigation tubes /SU A. C. N 1410990, A 61 M 27/00 - similar, he is the prototype/.The described device has the disadvantage of low positional stability, nepozvoljaet securely fix the drainage in a tightly closed abscess, preventing its spontaneous or unplanned migration, for example, when the forced change of the area of the loop of the irrigation tube. In addition, the location of the segments of the irrigation tube in the lumen of the suction reduce the useful working the last section, which reduces the efficiency at the "closed" drainage secuestradores zones of destruction, such as pancreatic character.The objective of the invention is improving the efficiency of the sealed drainage of abscesses.The problem is solved by the fact that the irrigation tube drainage performed in multiple different planes along the longitudinal axis of the suction tube, each one plugged end rigidly fixed to the working end of the suction tube and free - placed coaxially in a semi-closed slots on the outer surface of the latter with the possibility of reciprocation and the formation of the working end of the suction tube reset system is achieved by introducing into one or more irrigation tubes throughout their length commensurate with flexible mobile core.In Fig. 1 shows a General view of the proposed drainage:
1 - suction tube with side holes;
2 - irrigation tube with side holes;
3 - "muted" the end of the irrigation tube;
4 - the free end of the irrigation tube;
5 - the loop variable area irrigation tube;
6 - semi-closed slot of the suction tube;
7 - flexible movable core;
8 - retainer clip.In Fig. 2 is a longitudinal section of the proposed drainage along the irrigation hinges with locking flexible movable core.In Fig. 3 - stages of installation of drainage into the cavity of the abscess:
9 - initial position, the irrigation pipe as drawn in semi-closed slots of the suction tube;
10 - working position in one of the formed irrigation loops introduced a flexible movable core.The device is used as follows.In the cavity revealed abscess surgery or using minimally invasive technologies /for example, under control of the ultrasonic scan/ create access, commensurate with applicable drainage. Through the access cavity destruction introduces the proposed drainage louvetot the provisions of the drainage of purulent cavity is controlled by sonography and /or/ radiographically. Then, creating a force on the free end of the irrigation tube 2, is injected into the drained cavity, creating raznovozrastnye irrigation loop 5 before working end of the suction tube 1. After that, one or two irrigation tube 2 are inserted flexible cores 7, splinting a selected irrigation loops 5, which creates a customized according to the size and geometry of the drained area of destruction of the system of fixing, stabilizing suction tube 1 in the selected position. Mutual mobility of the core 7 and the irrigation tube 2 is fixed retainer clip. When this flow of flushing fluid into the cavity of the destruction is carried out through the remaining free irrigation tube 2 and the outflow through the suction tube 1. In the process of treatment according to the results of sonography and x-ray examinations are changing the area of retention and leaching irrigation loops 5, and if necessary change them together.An example of a specific application.Patient M., 49, history N 10281, was admitted to the Department of purulent surgery Bureau N1 23.06.98 with a diagnosis of Nobiliary pancreonecrosis, left-sided retroperitoneal abscess. Ultrasonography revealed accuzone exudation, usual semi-rigid J-conductor, dilatational system bogey and created percutaneous access with a diameter of 11 mm. wound channel in the cavity of destruction initiated the proposed device in the assembled state is maximally retracted irrigation tubes. Under sonographic control the selected optimum position of the drainage cavity destruction. After that, making the effort consistently for all three irrigation pipes of the drainage system, were formed raznovozrastnye irrigation loops in the area of the working end of the suction tube. Then in one of the tubes has introduced flexible proportionate to the core to stiffen the drainage system, while the core has executed a selected irrigation loop, and at the free end of the irrigation tube it was fixed with a clip. Drainage was slightly improved for the suction tube to the feeling of elastic resistance through the locking loop and attached to the skin. Wash liquid is introduced through the free ends of the two nesinervink irrigation tubes, and was utekala through the side holes on the suction pipe of the drainage system. When this drainage is freely leave not only the liquid pus, and tissue sequesters. Long trenirovka the stable position the entire period of drainage. The drainage containing the irrigation and suction tube with side holes, and the irrigation tube forms a loop variable square in front of the working end of the aspiration tube, wherein the irrigation tube drainage performed in multiple different planes along the longitudinal axis of the suction tube, each one plugged end rigidly fixed to the working end of the suction tube and freely - placed coaxially on the outer surface of the latter with the possibility of reciprocation, and the positional stability of the system is achieved by introducing into one or more formed irrigation tubing loops over the entire length commensurate with flexible mobile core.
SUBSTANCE: method involves conducting bougie through the liver. Flexible tube is attached to its end and set in bile ducts. Flexible radio-opaque conductor is introduced through the flexible tube. The tube is removed. Draining tube is introduced along the conductor from porta hepatis to its diaphragmatic surface into the ducts to be drained.
EFFECT: reduced risk of traumatic complications.
SUBSTANCE: method involves puncturing pyogenic abscess cavity under ultrasonic control with draining tube left therein. Laparoscope connected to monitor unit is introduced into abscess cavity. One of introduced drains is set in upper point of the cavity and the other one in lower point. The abscess cavity is filled with ozonized solution to 2/3 of its volume and bubbled with ozone-oxygen mixture during 2-3 min changing the solution until it becomes transparent. The emptied cavity walls are treated from distance of 3-4 cm with laminar airflow heated to 38-40°C under pressure of 1-1.5 atm during 2-3 min. Next to it, the cavity walls are irradiated from distance of 2-3 cm with non-coherent red light during 2-3 min per each area.
EFFECT: improved safety conditions and healing quality.
FIELD: medical engineering.
SUBSTANCE: device has suction tube having lateral openings and irrigation tube. The irrigation tube is connected to jet-action atomizer. The atomizer is hollow collapsible cylinder with holes. Ultrasonic radiator having conductor to ultrasonic frequency oscillator is available in the cylinder. The radiator and conductor enable one to introduce ultrasonic oscillations into antiseptic solution.
EFFECT: enhanced effectiveness of treatment.
SUBSTANCE: method involves puncturing pyogenic cavity with trocar having blunt obturator via skin incision made outside of abscess boundary having length equal to arthroscope diameter. Then, arthroscope is introduced and the cavity is filled with physiologic saline. Pyogenic cavity revision is carried out under arthroscope control, irrigation cannula is set, constant water medium is created. Arthroscopic mill on shaver handle is introduced via another skin incision. Non-viable tissues are removed with stage-by-stage hemostasis using endocoagulator. The cavity is healed. Perforated draining tube is set under arthroscope control. Tube ends are brought out through pierces outside of the cavity and sutured to skin. Active suction of wound exudates is carried out using closed vacuum drain system in postoperative period. The drainage is removed when cleaning the wound from wound microflora and single sutures are placed.
EFFECT: enhanced effectiveness of treatment.
FIELD: medicine, abdominal surgery.
SUBSTANCE: the present innovation deals with treating patients in case of destructive forms of pancreatitis. One should lance a gastro-colic ligament, mobilize splenic and hepatic angles of large intestine, tighten a middle colic artery, descend mesenteric root cross-sectionally against a colon, dissect parietal peritoneum along the upper and lower edges of pancreas to withdraw it into abdominal cavity, remove necrotized tissues. Then one should apply a rubber balloon with drainage tubes along its upper and lower edges into omental cavity: one balloon's end should be withdrawn through median wound, another one - through contra-aperture being 5 cm below a costal arch along median axillary line. The method suggested enables to form adequate access to patient's pancreas.
EFFECT: higher efficiency of drainage.
6 dwg, 1 ex
FIELD: medical engineering.
SUBSTANCE: device has liquid-permeable porous lining that is to be placed on or in a wound, flexible plastic film having a set of holes distributed over its surface, liquid-impermeable film napkin and connection means. The porous lining has foamed polymer material having interconnecting cells. The plastic film makes contact with porous lining surface and is between wound surface and the lining when used. The film napkin is placed above the porous lining and is sticky along its perimeter to provide sealing in skin area surrounding the wound. The connection means passes through the film napkin and communicates to porous lining via liquid flow for making connection to negative pressure source for stimulating fluid flow discharged from the wound. Another embodiment has removable wound bandage usable in particular for treating large wounds requiring draining fluids. It has the first porous lining, the second porous lining, elastomer envelope, film napkin and tubular connection means. The first liquid-permeable porous lining contacts the wound and has foamed lining having foamed material based on polymer built of interconnecting cells and isolated transverse holes. The elastomer envelope has the first and the second sheets of elastomer film soldered along their periphery and enveloping said foamed lining. Each of the first and the second elastomer film sheets has spaced-apart holes. The holes in the second sheet are justified with said spaced-apart holes in the first sheet. The second liquid-permeable porous lining is to be placed under the first porous lining. It has foamed polymer material having interconnecting cells. The liquid-impermeable film napkin is placed above the second porous lining. The first porous lining is placed above the wound. The film napkin is sticky along its perimeter to glue the napkin to skin area surrounding the wound. The tubular connection means passes through said film napkin and communicates to porous lining via liquid flow for making connection to negative pressure source for stimulating fluid flow discharged from the wound. The third embodiment has the first elastomer film sheet having spaced-apart holes deviated from spaced-apart holes in the foamed lining. The second elastomer film sheet has spaced-apart holes adjusted to the spaced-apart holes in the foamed lining.
EFFECT: simplified usage; accelerated wound healing.
15 cl, 3 dwg
FIELD: medicine, surgery.
SUBSTANCE: one should perform decompression of Wirsung's duct with the help of silicone instrument or catheter in case of pancreatogastrostomy in the course of pancreatoduodenal resection. Moreover, the above-mentioned instruments should be fixed in anastomosis with one of the sutures in internal row, their free ends should be loosely located in the stomach and tightened to caprone ligature to be then withdrawn through patient's nose. In 7-10 d either silicone instrument or catheter should be removed due to pulling by caprone ligature. The innovation enables to decrease the risk in the failure of pancreatogastroanastomoses and post-operational pancreatitis.
EFFECT: higher efficiency of draining.
FIELD: medicine, surgery.
SUBSTANCE: at the end of the main stage of operation conducted one should perform paravertebral Novocain blockade by puncturing the sheath of m.erector trunci, the drainage should be introduced towards lateral edge of m.ilipsoas through paracentesis of lumbar area being about 1-2 cm above ilium's ala at the line made via the end of the 12th rib vertically up to ilium's ala. Retroperitoneal space should be, also, drained. The innovation enables to prevent purulent-septic complications and decrease the pain.
EFFECT: higher efficiency.
1 dwg, 2 tbl
FIELD: medicine, obstetrics, gynecology.
SUBSTANCE: uterine cavity should be drained in the course of operation, moreover, irrigator's distal end should be withdrawn through operation wound at anterior abdominal wall, and 2 h after the end of operation uterine cavity should be washed through irrigator with 400 ml of cooled 0.06%-sodium hypochlorite solution at perfusion rate being 200 ml/h, 6 times every 12 h up to 3-4 d; after each perfusion one should introduce 1 g kanamycin directly into uterine cavity, moreover, in case of availability of bacterioid and/or anaerobic flora in uterine cavity according to the results obtained due to pre-operational antibioticogram one should add 100 ml 3%-hydrogen peroxide solution into perfusion solution. The present innovation enables to efficiently sanitize uterine cavity due to intrauterine injection of antibiotics by taking into account antibioticogram performed at all stages of operative treatment.
EFFECT: higher efficiency of prophylaxis.
1 cl, 2 ex
FIELD: medical engineering.
SUBSTANCE: device has lateral holes and is manufactured from absorbable material like polydioxanon. The holes are diametrically arranged in two rows along the whole tube length in chessboard order in the first embodiment of the invention. The absorbable material of polydioxanon is manufactured as threads arranged as reticular mesh grid structure of 12-20 u/cm in building tube walls.
EFFECT: eliminated occurrence of pyo-inflammatory complications.
2 cl, 2 dwg