1. “ Surgical Drains” Professor Magdy Amin RIAD Professor of Otolaryngology. Ain shames University Senior Lecturer in Otolaryngology University of Dundee

2. Why use Drains ? Haematoma Other Fluids (serous, chyle, pus, etc) Tissue adherence -- cosmesis

3. The Perfect Product Greater tissue contact Inert material. Slides smoothly past any tissue Promotes ease of movement and deep breathing Minimal pain on removal Comes in various sizes

4. Type of Drains Suction Non - Suction Materials Via wound Separate site

5. Principles of Drain Placement Maximum area Minimal trauma (nerves, vessel repair ) Memory of materials Gravitational Cosmetic Patient comfort Ease of removal

6. Packs Abscess cavity Infected wound Must not adhere to healing tissue (fibrin) Must contain an anti septic must be replaced frequently.

7. wicks Fistulae. Discharging sinuses. Same principles of packs.

8. Cigarette drain Sheet drain wrapped around a wick or pack Keep tract opened and drain the inflammatory exudates. Require less replacement

9. Corrugated rubber drain Sheet drainage Simple insertion, care and removal. Not expensive. Tissue irritant.

10. Yeates drain Parallel tubes. Side and end holes. Thick fluid can block drainage.

11. Tube drain When air tight seal could not be obtained. Suction machines can be connected intermittently.

12. Suction drainage Most effective method of drainage. Require air tight seal. Closed drainage. Allow better tissue coaptation.

13. Problems with Drains Obstruction Lost seal Suction system Diameter vs Fluid Patient mobility Removal

14. Wound principles

15. Skin Placement

16. Suction Channels

17. Drain Length

18. Placement

19. Trochar removal

20. Fixation

21. Suction “Tip”

22. Suction adaption

23. Skin Closure

25. pack suction

27. Drain “Organiser”

28. Patient issues Post Op