The method of drainage is often used in the treatment of sore of the lungs. However, many doctors do not understand the principles of The implications of the drainage systems of the pleural cavity do not know how to eliminate disturbances in their work. This chapter discusses various drainage introduction methods and various drainage systems, as well as recommendations on how to eliminate violations. Indications for drainage in patients with pneu motorax, hemothorax, empyema and malignant diseases Levies are discussed in their respective chapters.
METHOD OF DRAINAGE OF THE PLEURAL CAVITY
Thoracostomy can be accomplished in two ways: by conducting a drainage torakostomii Th Res torakostomii trocar and with the introduction of drainage surgically. When administered for the purpose of aspiration drain pus, blood or any other fluid from the pleural cavity pain hydrochloric should be in the sitting position, since in such a situation the patient’s diaphragm occupies the lowest Posy tion, and the liquid is collected in the lower part of the thorax. In the case of pneumothorax when administered drainage tube front patient should be in the sitting position, leaning back, when administered drainage axillary line at the patient must be in a position lying on its side.
Thoracostomy, the introduction of drainage through the trocar
Using this methodology under local anesthesia parallel to the upper boundary edges produce skin incision and subcutaneous length 2-4 cm. Then the pleural by lethargy administered through intercostal trocar having a stylet, with the pym end so as not to damage the intercostal vessels. Since the introduction of the trocar is required defined divided by the power, then the other hand, do not make a trocar should be placed near the chest wall of the patient to controls Rowan injection depth. After introduction of the trocar in the pleural hydrochloric cavity stylet removed immediately covering trocar finger to not develop a pneumothorax. Through trocar fast ro enter the drainage tube with a closed distal end. Then, the trocar is removed from the pleural for Lost and drainage occluded in the section between the rib walls Coy and trocar to be able to remove the clip from the distal portion of the tube. This allows unhindered withdrawal of the trocar. Drainage must remain constricted until it is
The introduction of the trocar into the pleural cavity; note the position of the hands, race position relative to a trocar ribs, as well as the position of the end of the trocar (A). WWE denie drainage through the trocar (B).
connect with underwater aspiration system which will provide Vaeth preventing air from entering the pleural by lethargy.
The drainage tube is fixed by placing a suture around the drainage. The incision is sutured loosely, without the tension, not to just curled necrosis of surrounding tissues. Then treated with an opera -insulating box and put gauze pad the size of 4×4 cm, which is fixed plaster, both for the crepes they drain tube.
There is another method of introducing drainage through the trocar when the trocar is inside the tube. The administration procedure is the same as described above. After entering the pleural hydrochloric cavity inner trocar slowly removed from plevu tral cavity. Once the proximal end of the trocar is removed from the chest, between the trocar and the chest wall superimposed clip that you can safely carry the trocar on drainage and connect the drain with underwater si STEM aspiration.