Low Vacuum Drainage
Introduction:
Wound drains can be used when blood and lymphatic vessels are cut during surgery. Despite meticulous haemostasis performed by the surgeon a wound may continue to ooze profusely necessitating placement of a wound drain.
The usage as well as type of drainage system depends on the preference of the surgical team, procedure, patient and expected amount of fluid draining. If the wound is not drained, then a number of serious problems may occur including haematomas, infection, inflammation and pain. Such problems can increase the need for antibiotics as well as prolonging a patient’s stay in hospital.
A low vacuum drainage system is suitable for all procedures where gentle fluid removal is favoured especially when prolonged wound seroma production is foreseen. Low vacuum drainage may be used for several surgical procedures include breast, vascular, orthopaedic, gynaecology, general and some urological surgery.
Besides skin irritation due to hard plastic drains, much of the discomfort for the patient is caused by the frequent need to replace the bottles which collect the drained fluids. The latter often necessitates a hospital visit where medical staff has to change bottles. Systems in which emptying of the fluid collector as well as re-instalment of vacuum pressure to the drainage system can be performed by the patient her/himself may therefore be preferred.
How to use the Handyvac®:
The complete low vacuum drainage system comes in one sterilised package comprising
- a soft drain
- a compressible 125 ml vacuum chamber (initial vacuum 65 mm Hg)
- a drainage bag
Schematic overview
The compressible low vacuum chamber (3) is at the top connected to a large soft plastic tube ending in a twist and lock connector (1) and at the bottom a short plastic tube which can be connected to the drainage bag (6) also by a twist and lock connector (5). Both tubes can be temporary closed by blue clamps (2, 4). The drainage bag can contain 700 ml and can be emptied through a bottom outlet (7).
Step 1 Placement of the wound drain
The drain is placed into the wound and extruded through the skin using a trocar.
Separate the drain from the trocar using a large scissors. In order to properly fit the drain to the connector it should be cut at a right angle not oblique.
Step 2 Connection to the compressible vacuum chamber
It is of utmost importance that the twist and lock connector (1) is properly locked in order to prevent leakage and improper function of the low vacuum drainage system.
Once the connector is tightly screwed the patient drain can be connected to the tip of the plastic connector. In case of a slippery drain use a gauze to hold the drain more easier.
Step 3 Connection of the drainage bag.
Connect the drainage bag to the bottom of the compressible vacuum chamber, i.e. the short tube with twist and lock connector (5). Make sure that the bottom outlet (7) of the drainage bag is closed!
Step 4 Installing low vacuum pressure
Both blue clamps (2, 4) on either side of the compressible vacuum chamber should be in the “open position”. Compress the vacuum chamber (3). Repeat this manoeuvre until the vacuum chamber stays in a fully compressed form which corresponds with 65 mm Hg vacuum pressure.
Step 5 Re-instalment of low vacuum pressure
Due to persistent drainage the compressible vacuum chamber is filled up with fluid. Low vacuum pressure decreases with filling of the chamber resulting in passive drainage instead of active vacuum drainage. To re-install low vacuum pressure simple compress the compressible vacuum chamber thereby emptying the fluid in the large white collection bag. Clamps 2 and 4 must be left in the “open position”.
N.B.:
- Due to non-return valves in the compressible vacuum chamber fluids will not flow backwards.
- If it for some reason should be necessary to change the drainage bag both clamps (2, 4) must be in closed position.
Step 6 Disconnection and/or emptying of the drainage bag.
Before emptying the drainage bag, close the blue clamp (4) at the bottom of the compressible vacuum chamber. Clamp 2 can be left open.
The drainage bag(6) can be emptied through a bottom outlet (7).
Once the patient is mobilised on the ward or discharged from the hospital with the drainage system the drainage bag can be removed. Close the blue clamp (4) at the bottom of the compressible vacuum chamber. Unscrew the drainage bag from connector 5. The connector can be closed using a special cap (not shown).
Problems:
I cannot install low vacuum pressure.
Check if both connectors (1, 5) are tightly turned and locked.
Check if the bottom outlet (7) of the drainage bag is closed.
I cannot empty the compressible vacuum chamber
Check if the blue clamp (4) at the tube of the lower side of the compressible vacuum chamber is in the “open” position.
I lose vacuum pressure when the drainage bag is disconnected
Close the blue clamp (4) at the lower side of the compressible vacuum chamber.
4) How can I re-install vacuum pressure?
If the drainage bag is connected: compress the compressible vacuum chamber.
If the drainage bag is disconnected: open the blue clamp (4) at the lower side of the compressible vacuum chamber; subsequently unscrew the closing nipple of the distal connector and compress the compressible vacuum chamber.
Reference
This page was designed with support and approval of Unomedical a/s, the manufacturer of this low vacuum drainage system. The Handyvac® drainage system is an example of many low vacuum drainage systems available. For additional information click here.
Date of most recent change: Nov 1rst 2007.