After drainage - consequences. Drainage after surgery, drainage technique and tube care Requirements for drainage

) from a wound, body cavity, hollow organ using tubes, rubber and gauze strips, gauze swabs. During drainage, conditions are created for the constant outflow of contents.

Gauze swabs and gauze strips have limited use for drainage, since, when saturated with discharge, they quickly lose their hygroscopicity and stop removing the contents. Rubber strips (for example, made from glove rubber) are used in some cases in the postoperative period for drainage of wounds. As the amount of discharge from the wound decreases, they are removed. Most often, tubes made of synthetic materials and rubber of various diameters with several holes at the end inserted into the drained cavity are used for drainage. Before insertion, the drainage tubes are washed, their permeability and strength are checked to avoid tearing, and they are sterilized. A drainage tube is inserted through the wound or an additional one - counter-aperture (see). To prevent prolapse, the drainage tube is sometimes attached with a suture or to the skin. A gauze cloth is tied to the outer end of the drainage tube inserted into the cavity (peritoneum, etc.) so that it does not go deep. The tube at the level of its exit from the wound is tightly tied with thread; when the drainage tube comes out of the wound, the thread will be above the skin level; if it is immersed deeper, it will not be visible. To evacuate exudate from the pleural cavity, siphon drainage is used (Fig. 1). Through a trocar puncture of the intercostal space, a drainage tube is inserted into the pleural cavity, the end of which is immersed in a vessel with an antiseptic liquid. In some cases, when draining the pleural cavity, in order to avoid air suction from the outside, a rubber finger with a cut off top that collapses when inhaling is placed on the outer end of the drainage tube (the so-called valve drainage).

Rice. 1. Drainage of the pleural cavity

Rice. 2. Drainage of the bladder (1) and peri-vesical tissue (2)

To drain the kidneys, a drainage tube is inserted into the pelvis through its wall () or through (nephrostomy). When draining the bladder, the drainage tube is removed through the extraperitoneal part of its anterior wall (Fig. 2, 1). In case of extraperitoneal ruptures of the bladder and injuries of the urethra, to prevent urinary leaks after a high section of the bladder and the application of a suprapubic fistula, the peri-vesical tissue is drained through the obturator foramen with drainage being placed on the inner surface of the upper third of the thigh (Fig. 2, 2).

Active drainage can also be performed through a drainage tube (see Aspiration drainage).

The doctor installs the drainage tube, and then monitors the condition of the tube, the amount and nature of the discharge, and the color of the sediment. After the operation, you need to make sure that the drainage tube is not compressed, kinked, or putting pressure on the skin. It is necessary to ensure that the drainage tube is well secured and does not fall out. A prolapsed tube should be inserted immediately. This manipulation is performed only by a doctor. To monitor the amount and nature of discharge (especially after operations on the urinary organs and bile ducts), it is most convenient to lower the outer end of the drainage tube into a graduated vessel made of colorless glass. If there is a sharp increase in the amount of discharge or a change in its nature, the nurse should immediately inform the doctor.

The length of time the drainage tube remains in the wound or cavity depends on the nature of the surgical intervention (the timing of removal is determined by the doctor). Having discovered that the drainage tube inserted into the wound is missing, the nurse should immediately inform the doctor about this.

Drainage after surgery is an event that ends most surgical operations. Although some doctors believe that drainage slows down the patient's recovery and even increases the risk of complications. Who is right, and in what cases is it impossible to do without drainage?

What is drainage in medicine

The term “drainage” is translated as “drainage” and is used in a variety of areas, implying approximately the same thing. In medicine, drainage refers to the installation of a hollow tube into a postoperative wound, the other end of which is brought out. The purpose of this design is to ensure the evacuation (removal) of pathological contents to the outside to accelerate the healing of internal wounds and prevent the development of recurrent

You can also wash the wound cavity with antiseptics through the tube, which is also important after complex operations involving the opening of abscesses. Exudate cannot be completely removed: some of it continues to form for several hours after surgery. Postoperative drainage allows disinfecting solutions to be introduced into the cavity.

Curious! The first mentions of surgical drainage of wounds were found in the treatises of Hippocrates. And this is the 4th century BC.

Doctors who call for abandoning drainage are guided by the fact that an open connection between a postoperative wound and the external environment can easily lead to infection. Also, foreign bodies in the form of tubes remaining in the human body for a long time contribute to the formation of fistulas - channels formed by tissues and connecting internal organs with the surface environment. But these two problems can be prevented if you follow the basic requirements:

choosing the right type of drainage;
compliance with the technique of its installation (surgical drainage must perform its function regardless of the patient’s body position);
careful fixation;
proper drainage care (maintaining cleanliness, treating with an antiseptic);
timely removal of drainage (immediately after its function is completed).

Types of modern drainages

The type of drainage that will be installed for a particular patient will be determined by the surgeon. Its choice depends on several factors: the surgical field, the nature of the intervention, the amount and intensity of pathological fluids after surgery.

Passive

This type of drainage involves inserting thin tubes filled with sterile gauze into the wound cavity. Passive drainage is installed so that the outflow of contents occurs from the inside to the outside due to gravity. It will no longer be possible to treat the wound cavity with an antiseptic. Passive drainage is used for shallow, simple wounds.

Due to the thinness of the tubes (and in some cases they are just flat corrugated strips), removal of passive drainage does not create additional scars. The wound from it heals quickly and without traces.

Active

Suitable for deep and complex wounds. It involves the installation of a whole system of interconnected flexible tubes connected to a vacuum system. This could be a plastic accordion or an electric suction pump. With their help, not only purulent masses are evacuated, but also dead cells and particles of separated flesh.

By the way! The outside of the tube is also attached to the container or bag. This allows you to assess the quantity and quality of the pathological contents released and determine when it is time to remove the drainage (less than 30-40 ml per day).

The active type of wound drainage also includes flushing-flow surgical drainage. This is already a system of two parallel tubes, one of which removes the contents, and the second serves to introduce antiseptics and saline solutions into the wound cavity for washing.

Closed and open

This is another classification of postoperative drainages. Closed drainage is a type of drainage in which the outer end of the tube is ligated or clamped. This is precisely what allows you to avoid infection of the wound cavity from the outside. A syringe is used to evacuate contents or administer medicinal solutions.

Open drainage is not pinched from the outside. The end of the tube is placed in a sterile vessel to collect pathological contents. If you monitor the air condition in the room (regularly carry out quartzing and wet cleaning), as well as change the container on time and ensure its sterility, then there will be no problems with infection.

After what operations is drainage installed?

Drainage is necessary on enzyme-forming organs (stomach, pancreas, intestines, etc.), because in the first few hours or days after surgery, in addition to natural secretions, pathological contents will also form in them.

Also, drainage in surgery must be installed when opening ulcers on any part of the body, even if it is a superficial operation under local anesthesia. In this case, passive drainage under a bandage is suitable, which is removed after a day.

Sometimes wounds resulting from plastic surgery are drained. The drainage system in such cases makes it possible to monitor the absence of internal bleeding. Many doctors drain the mammary glands after breast augmentation surgery because installed implants take root faster and better in a dry cavity.

Caring for drainage tubes, algorithm

Since the drain is installed on a patient who has just undergone surgery, the entire responsibility for caring for the system falls on the shoulders of the medical staff. The patient is only required to monitor the position of the body so that the tubes are not bent or pinched.

Important! Neither the drainage tube nor the wound should be touched with your hands! This may cause infection, cause bleeding, or prevent proper placement. If your drain needs to be corrected, you should call a nurse.

The vessel or bag in which the contents are collected is changed as it is filled. Before emptying and drying the container, the nurse shows it to the doctor to assess the quality of the drainage system and the need to extend it. While the container is being changed, the lower end of the tube is clamped to prevent infection from entering the wound cavity. The clamp can only be removed after an empty sterile vessel has been installed.

Removal of the drainage system is carried out in an operating room or dressing room. If this is passive drainage, they are limited to treating the abdominal wound with an antiseptic and applying a bandage. Active drains require suturing the holes into which the tubes were inserted and applying sutures.

If you neglect wound drainage for fear of the risk of developing complications in the form of fistulas and infection, you can get even more serious consequences. Suppuration and a constant increase in the amount of exudate can lead to pus spilling into free cavities and leading to inflammation of nearby organs. And this is acute intoxication with fever, which can lead to the death of a person weakened by a recent operation.

Follow your doctor's directions. Most importantly, follow your doctor's directions on how to care for your drains. These tips are not intended to replace your doctor's instructions!

Understand how drains work. After removing a large amount of tissue from the body, the body tries to fill the space with fluid. This fluid will slow down the healing process. The purpose of drainage systems is to remove fluid. The drain is essentially a simple device and consists of three parts: (a) a flat part with holes that is located inside the body, (b) a tube running from the flat part through a small cut on the outside of the body, and (c) a plastic bulb at the end of the tube. The plastic flask has a small spout and cap. After you open the cap, you need to press on the flask to release the air, then you need to close the stopper and the gentle suction of air over time will draw the liquid from the body and release it into the plastic flask. Liquid accumulates in the flask and needs to be emptied from time to time.

Wear the right clothes. Wear loose clothing and make sure nothing is blocking the drainage. Drainage systems should be located near your body and protected.

Secure the drain. The flask has plastic loops with a fastening strap that can be attached to your shirt with a pin. Under no circumstances should you attach the flask to your pants! If you forget it's there and pull down your pants, you could pull the drain completely out of your body, requiring an emergency trip to the doctor! In addition, you can make a small bag to store the drainage and hang it around your neck with a string. Just make sure the drain is at about waist level, otherwise the fluid won't drain properly, slowing down healing time. For this reason, do not keep drainage in your shirt pocket. It's too high.

Create a schedule for emptying the drain. Your doctor will give you instructions about how often to clean your drain. The instructions will likely recommend doing this every 12 hours. Choose a time that does not interfere with your sleep.

Empty the drain. You may need to ask someone to help you with this.

Empty the drain. You may need to ask someone to help you with this. Gather everything you need for this. On a clean surface, gather clean gauze packs, gauze pads (large gauze pads), an oral thermometer, surgical tape, soap and water, a measuring cup (a special type that can be obtained from your doctor), and your recording sheet.
Wash your hands. Wash your hands with soap and water.
Remove the bandage. Loosen the dressing tapes and carefully remove the old dressing. Throw it away.
Inspect the area where the drainage is located. Examine it for new redness, swelling, or foul odors. Check to see if any stitches have fallen out. If you see any of these, call your doctor and report it when you've finished emptying the drain.
Wipe the area where the drain is attached. Wipe the area around the cut with soap, water, and a clean gauze pad. Move away from the cut. Remove the soap and let the air dry your skin.
Change the bandage. The new gauze bandage should completely cover the drainage area, but should not catch the plastic tubes. It needs to be placed UNDER the tubes. You can use scissors to cut the gauze bandage from one edge to the center, and then place the bandage under the tubes so that the tubes pass through the center. You can also use two gauze pads folded in half, placing one under the tubes and one above the tube. Secure the gauze with bandages.
Drain the water from the drain hole. If there are two drains, they need to be marked (for example, “1” and “2”, “a” and “b”, “upper” and “lower”, etc.). Pick one and always empty it first before the other.

Take a measuring cup. Your doctor should have given you a measuring cup (such as a container to collect urine). On the side of such a container there should be gradations in the form of cc (cubic centimeters) or ml (milliliters). Open the cup and place it on the surface.
Open the flask. Take the flask that you will empty first. With your other hand, remove the stopper from the spout of the flask.
Drain the liquid from the flask. Hold the spout over the measuring cup, invert the flask and pour the contents from the flask into the glass. You won't be able to drain everything completely, but try to drain as much as you can.
Squeeze the flask to release the air. Turn the flask over to the correct position. Remove most of the air from the flask and close the stopper. The flask should have indentations that create a vacuum to collect fluid from your body.
Secure the flask. Clip the flask to your shirt or put it in your bag.
Measure the amount of liquid. Look at the liquid and determine its volume in cubic centimeters (cc) or milliliters (ml). Record this figure in the data recording table.
Record color, uniformity, and odor. Record the color and clarity and note if you notice any unpleasant odors. Immediately after surgery, the fluid should be smooth and red. As it heals, it should decrease in volume and acquire a natural pink or pale yellow color.
Flush the liquid down the toilet.
Take your temperature. Write this down too.
Drain the second drain. If you have two drains, empty the second drain and record the data.

16Dec

In what areas is drainage used, types of drainage?

Drainage is a natural or man-made system that serves to collect and drain excess amounts of various liquids from certain objects, surfaces and containers. Today it is difficult to find a branch of human activity where this device is not used. Medicine, construction, aviation, technology, agriculture, floriculture and plant growing would hardly be able to develop qualitatively and fulfill all their tasks without the installation of drainage systems.

In simple terms, drainage means drying, so this system, regardless of the place of application, has the same operating principle. Nevertheless, each drainage system has its own design features and types. And only after familiarizing yourself with all of them can you understand why drainage is needed in medicine, and what its similarities and differences are with the drainage system used, for example, in floriculture.

Materials for medical drains

Drainage in medicine is used mainly to remove accumulated fluid, pus or blood from a body cavity, organ or wound, the natural removal of which is disrupted due to injury, wound or after surgery. The drainage system can be done using:

plastic or vinyl chloride medical tubes;
gauze and rubber strips;
sterile swabs and bandages.

Each type of such drainage is selected depending on the type of operation performed and the depth of the resulting wound. If internal bleeding occurs or purulent arthritis becomes inflamed, then drainage is inserted through an additional incision or puncture on the body. And only after surgery, drainage is performed through the incision left from the operation.

The task of installing medical drains is to remove blood, tissue breakdown products and microorganisms from the body cavity, which, when accumulated, can cause serious complications. And the body’s immunity after any operation is greatly weakened and can no longer find the strength to fight a new inflammatory process. It is drainage that helps the body significantly speed up the healing time of wounds.

What influences the choice of medical drainage

Gauze swabs, bandages and strips are used extremely rarely and only for shallow wounds or abscesses. The thing is that this type of drainage cannot absorb liquid contents for a long time and therefore quickly loses its hygroscopicity. Accordingly, it ceases to provide high-quality outflow of fluid.

Various types of strips are used mainly after a simple surgical operation performed on soft tissues or extremities. The strip is inserted into the wound and gradually removed as the purulent and bloody contents decrease.

But still, the most common type of drainage in medicine is synthetic and rubber tubes of different lengths and different diameters. The end of the tube that is inserted into the injured cavity has several holes, which facilitates better outflow of liquid contents. A drainage tube is installed by the doctor at the end of the operation. But further monitoring of the condition of the drainage, the amount, color and nature of the fluid released is already carried out by the nurse.

Before inserting a drainage tube into an operated organ or injured cavity, it must be checked for strength and patency, after which it must be washed and sterilized.

Types of medical drainage

Drainage can be done not only with different materials, but also with the help of additional devices, the use of which depends on a number of factors. It is the use of additional funds that determines the type of drainage, which can be:

passive;
active,
flow-aspiration;
vacuum;
siphon.

Each type of such drainage is used, depending on the complexity and type of operation. Thus, the vacuum method is used when the drained cavity is completely closed. This could be a stitched suture left after surgery, purulent arthritis, inflammation of the pleura, or an internal abscess. But siphon drainage allows you to introduce antiseptic drugs, antibiotics and even necessary enzymes into a purulent wound, thereby significantly speeding up the healing process.

Drainage in crop production

Medical drainage is an essential device that helps a person recover quickly from severe injury, surgery, and other health problems. But it turns out that the principle of the drainage system not only helps solve medical problems, but is also necessary for growing plants.

Both experienced gardeners and indoor plant lovers know that in order for a flower to develop properly, it must not only be watered regularly, but also ensure that excess water does not harm it and its root system. That is why experts recommend first creating a drainage system in a flower pot, and only after that replanting indoor plants. Drainage in plant growing not only removes excess moisture, but also serves for air exchange, since the root system of flowers not only drinks water, but also breathes.

Types of drainage material

Unlike medicine, the drainage system in crop production is much simpler and more diverse. Drainage for indoor plants - this is a layer of material laid out in a pot, which should be able to easily pass and drain excess water when watering. Such material could be:

expanded clay;
pebbles;
broken bricks;
crushed stone;
charcoal;
foam granules;
pine bark.

The thickness of the drainage layer depends on the type of pot for indoor plants, as well as on the presence of a drainage hole on it. It is also worth paying attention to the characteristics of the flower itself. So, if there is a drainage hole on the pot, then lay out a 1 cm layer of drainage on its bottom. If there is none or it is very small, then it is better to pour material 3-4 cm thick.

Best drainage for indoor plants

Most often, expanded clay drainage is installed for indoor plants. The advantage of this material is that it absorbs moisture very well, and then gradually gives it to the ground.

Expanded clay can be bought without any problems at any flower shop. Due to the fact that it has three different fractions: large, medium and small, it can be used for absolutely all indoor plants. But the most important thing is that this material has a long service life, and it can even be used as a soil loosener. Crushed stone, pebbles, charcoal and many other drainage materials are good in their own way. You just need to be able to choose them for each specific case. In addition, drainage can also be combined. So, for indoor plants with heavy and fleshy leaves, it is better to use heavy material as drainage. But for those who prefer light dehumidifiers, you can put a few stones at the bottom of the pot and thereby weigh down the entire flower structure.

But still, unlike medicine, in floriculture you can experiment and use trial and error to find the right solutions. After all, incorrectly installed drainage for a plant can always be corrected without causing much harm to the plant itself, which cannot be said about the consequences that incorrectly installed medical drainage can lead to.

Moscow State Academy

veterinary medicine and biotechnology named after. K.I. Scriabin

Department of Veterinary Surgery

Course of operative surgery with topographic

animal anatomy

DRAINAGES

Checked:

Akimov A.V.

Moscow-2007

DrainAndroving(eng. drain drain, drain) - ensuring the outflow of the contents of wounds, abscesses, various cavities and hollow organs. Is the main one among physical methods antiseptics. Drainage can be done with rubber, vinyl chloride and other tubes of various diameters (drains), rubber or gauze strips, which are inserted into the wound, abscess cavity, joint, pleura, abdominal cavity, etc.

Drains

Definition. Drains are implants that are temporarily placed in wounds or body cavities to remove and drain fluids or gases.

Depending on the operating principle, there are two types of drains:

A) passive drainages;

B) active drainages.

The action of passive drainages is based on gravity, capillary diffusion or pressure of fluid accumulated in the wound. This pressure is caused by tissue movement or external dressings. Discharge (secret) flows along the surface of the drainage tube. The effectiveness of passive drainage depends on the surface properties of the drainage tube. Common passive drainage systems include Pensore drainage, corrugated tube drainage, and gauze drainage.

Pensore type drainage.

For such drainage, soft rubber tubes of various diameters are used. To ensure clearance, a gauze turunda can also be inserted into such a tube. As a rule, the secretion flows along the outer, although sometimes along the inner surface of the tube.

Drainage with corrugated pipes.

Rubber or plastic tubes of various shapes and sizes are used here. Drainage of this type is used primarily to drain pus from infected wounds and abscess cavities.

Gauze drainage.

It is used, as a rule, for tamponade of large abscess cavities, after dissection of the nose, etc.

Ring drainage. It is made in the form of a ring. In this case, the middle part of the drainage tube is located in the wound cavity or in the abscess cavity, and the two remaining ends are tied outside. When removing the ring drainage system, it is not allowed to pull the tubes that were located outside through the wound cavity, since they are not sterile. Therefore, before removing the system, the drainage tubes are cut with sterile scissors immediately before the inlet or outlet.

For a ring drain, it is best to use a gauze drain or a Penrose type drain, as this allows you to tie a knot. When using a flexible tube for ring drainage, you first need to thread a thread through it, the ends of which are tied directly at the exit points.

Active drainage systems include those in which wound fluid or gas is sucked out by creating a reduced pressure. The drainage system consists of a flexible tube with several small holes in the wall, the end of which is located in the wound or cavity. The vacuum is created mechanically (suction apparatus) with a negative pressure cylinder (Redon type drainage) or using a blocked disposable syringe. To control the effect of vacuum when using a suction apparatus, a cylinder filled with water is used. The height of the water column should not exceed 80 cm, and for chest drainage - 30 cm, to prevent tissue suction and blockage of the system.

The advantage of such drainage systems is that they do not clog immediately and, in addition, are closed systems, which minimizes the risk of wound infection.

Drains must ensure adequate drainage of contents and be chemical and biological inert. Pus, tissue decay products, and with them microorganisms are released through one or more drainages and evacuated into special containers or into a bandage. The drainage can be connected by a tube to a vessel containing a solution of an antiseptic drug (siphon drainage). In addition, solutions of antiseptic drugs, antibiotics, and proteolytic enzymes can be injected into a wound or purulent cavity through drainage ( rice. 1 ) For D. of the pleural cavity, siphon underwater drainage according to Bulau is used.

Gauze swabs have limited use for drainage, because when they become saturated with discharge, they quickly lose their hygroscopicity and stop removing it. Rubber strips (eg, made from glove rubber) are used in some cases in the postoperative period to drain wounds. As the amount of discharge decreases, the drainage is removed from the wound. Most often, sterile tubes of various diameters made of synthetic materials or rubber are used for D. There are several holes at the end of the tube inserted into the drained cavity. The drainage tube is inserted through the wound (Fig. 1) or an additional incision - a counter-aperture. To prevent the drainage tube from falling out, it is fixed to the skin with a suture or adhesive tape.

Aspiration D. in the treatment of purulent surgical diseases is often combined with active long-term washing of the drained cavities (flushing drainage). For example, antiseptic solutions, solutions of proteolytic enzymes or proteolysis inhibitors are poured into the abscess cavity, into the abdominal cavity with peritonitis, into the chest cavity with pleural empyema, into the bone cavity with osteomyelitis through an additionally introduced drainage. sucked out using aspirators through a drainage drain.

For more effective washing of wounds and purulent cavities, in addition to one drainage, a second tube is inserted into them, and through it a solution of an antibacterial drug, along with which the wound discharge is removed from the wound. This method is also used in the treatment of purulent pleurisy and peritonitis.

When the drained cavity is sealed (sutured wound, pleural empyema, purulent arthritis, unopened abscess), long-term active aspiration is possible (so-called vacuum drainage). A vacuum in the system can be created using a Janet syringe, which removes air from a sealed jar with a drain connected to it, or using a water-jet suction, a three-can system, a standard accordion-type apparatus, or an electric vacuum apparatus. This is an effective method of D., which also helps to reduce the wound cavity, more quickly close it and eliminate the inflammatory process ( rice. 3 ), and with pleural empyema - straightening of the lung compressed by exudate.

Vacuum D. is widely used for the prevention and reduction of wound healing time after extensive operations (plasty of the anterior abdominal wall, mastectomy, abdominoperineal extirpation of the rectum, after operations on the lungs and mediastinal organs), for the treatment of spontaneous pneumothorax and pleural empyema. In abdominal surgery, aspiration of the stomach and small intestine is used for the prevention and treatment of paresis of the gastrointestinal tract, prevention of anastomotic suture failure, treatment of abdominal abscesses, cysts and abscesses of the liver, spleen and pancreas.

When treating wounds, gauze swabs of various sizes, which are prepared from a strip of gauze, are also used as drainage. Due to its hygroscopicity, the tampon absorbs blood and exudate, but its drainage properties are manifested no more than 8 h. Then the tampon can become a kind of plug, clogging the wound and disrupting the outflow of exudate from it. The drainage properties of the tampon increase when it is moistened with 5-10% hypertonic sodium chloride solution, which, by increasing osmotic pressure, enhances the outflow of fluid from the wound. A type of gauze tampon is the Mikulicz tampon. It consists of a large gauze pad, placed on the bottom and walls of the wound, and gauze swabs, which are used to fill the resulting bag. As the tampons become saturated with wound discharge, they are replaced with new ones until the outflow of discharge stops. After this, it is removed by pulling the thread sewn to the middle of the napkin.

Complications of D. are prolapse of the drainage tube, hematoma formation and marginal necrosis, wound suppuration. With prolonged drainage pressure on the vessels, arrosive bleeding is possible, and with pressure on the intestinal wall, it can become bedsore and form an intestinal fistula.

Drainage of the urinary tract is carried out using instrumental and surgical methods. Instrumental D. is carried out by catheterization of the bladder or renal pelvis if their emptying is impaired. If long-term drainage of the upper urinary tract is necessary, suspended catheterization with a self-retaining “Stent” catheter is used. Fixation of the catheter is determined by twisting the proximal and distal ends of the catheter in the renal pelvis and in the bladder after removing the string that straightens the catheter. Surgical D. of the urinary tract can be an independent intervention or the final stage of various urological operations. D. of the renal pelvis is more often used (through its wall - pyelostomy or through kidney tissue - nephrostomy). Percutaneous puncture nephrostomy under X-ray or ultrasound control is also used. D. of the bladder above the pubic symphysis (epicystostomy) can be performed surgically or by puncture with a special trocar (trocar epicystostomy). Nephrostomy and cystostomy drainage tubes must be securely fixed to the skin with a ligature and secured with a belt. Ureteral catheters, external catheters of the “Stent” type, urethral catheters are fixed to the skin with an adhesive tape and ligature. Washing of cystostomy drainage tubes and urethral catheters is carried out when they are occluded by clots of detritus, pus, blood, or small sand (50-80 ml) the amount of antiseptic solution. Washing of nephrostomy drains, ureteral catheters, external catheters of the “Stent” type must begin with urine aspiration, if unsuccessful, no more than 2-3 ml any antiseptic solution.

BIBLIOGRAPHY:

1. “General Surgery”, ed. V. Schmitt et al., vol. 2. p. 62, M., 1985; Wounds and wound infection, ed. M.I. Kuzina and B.M. Kostyuchenka, s. 353, M., 1981; Struchkov V.I., Gostishchev V.K. and Struchkov Yu.V. Guide to purulent surgery, M., 1984.

2. Shebits H., Brass V. “Operative surgery of dogs and cats”

3.I. D. Kanorsky, B. I. Fidrus. "Medical Encyclopedia"