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| An active drain is placed on the ventrum of a 2-year-old male cat with a necrotic wound. (Courtesy of Dr. Zeltzman) |
Drains are often used to help treatment of infected wounds, but they can also be very helpful after excision of large skin or subcutaneous masses. This is not a new idea; early surgeons, during the 19th century, thought of using glass tubes to drain infected wounds.
Indications for drain placement include reduction of dead space and prevention or reduction of fluid collection. This in turn decreases the risk of infection, since inflammatory fluid, necrotic tissues and blood are excellent culture media. Respecting some basic guidelines will help speed up the healing process.
There are two main types of drains: passive and active.
Passive latex drains are most often Penrose drains, although a sterile piece of IV tubing or a red rubber catheter can be used in a pinch. Fluids leak along the outer surface of the drain, so cutting fenestrations into it actually reduces its efficacy and makes the drain more likely to tear.
Passive drains rely on gravity and therefore must exit ventrally. Letting a drain exit through a dorsal incision defeats its purpose. Moreover, it creates a second opening through which bacteria can enter and cause an infection.
It is, however, a great idea to suture the drain dorsally to prevent its slippage, -usually in a blind fashion. The dorsal end of the drain can be held at the tip of a long pair of hemo...
Copyright 2009 BowTie Inc.
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