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Drains and surgical healing

Article-Drains and surgical healing

surgical drain

The SOMAVAC 100 (SOMAVAC Medical Solutions) post-surgical pump is the first innovation to manual pumps in decades, according to the company.

The current standard of care to post-surgically remove fluid from closed wounds and reduce seroma risk is to use closed-suction systems that draw out fluid with manual suction. A flexible suction bulb attached to the end of the drain generates the suction.

SOMAVAC 100 is FDA cleared and indicated for use in surgeries that lead to large surgical flaps requiring drains, such as abdominal surgery, mastectomy and related cosmetic surgeries. The device applies continuous suction to closed postsurgical wounds, which researchers have found is important for effectively removing fluid, bringing tissue planes together and, possibly, to help with healing. Today’s manual suction bulbs lose pressure as they fill, preventing many from providing adequate continuous suction.

SOMAVAC 100 eliminates the need to empty and recharge the bulb. Rather, users replace filled collection bags and change the batteries when needed, which helps diminish odors.

“… the drain and pump can be discretely worn under clothing which aids in helping patients return to normal activities while recovering,” according to press information on the SOMAVAC 100.

Jeffrey E. Janis, M.D., professor of Plastic Surgery, Neurosurgery, Neurology and Surgery at Ohio State University Wexner Medical Center in Columbus, says it’s true that advances in drain technology and what he calls “drain hygiene” are long overdue.

Dr. Janis and colleagues wrote “Optimal Use of Surgical Drains: Evidence-Based Strategies,” published June 2018 in Plastic and Reconstructive Surgery to help define parameters that impact drain efficacy in standard drain use.

One of the issues with the standard drains is that doctors and patients don’t always follow evidence on how best to use manual drains, Dr. Janis says. He and his coauthors did a comprehensive literature review and in vitro analysis of variables that affect drain function.

Among their findings: “Bulbs generate more effective suction when squeezed ‘side-to-side’ than when squeezed ‘bottom-up,’ and evacuators were only able to generate half the maximal negative pressure when 25 percent full or greater. Stripping the drain tubing helped relieve obstruction caused by clotting.”

SOMAVAC 100 technology automates many of the potential hurdles to correct use, according to Dr. Janis, who is familiar with SOMAVAC 100 but uses standard drains at Ohio State University.

“This new technology automates some of those features, so that it makes it lower maintenance for doctors and patients, which is always a good thing,” he says. “At the end of the day, I don’t know anybody who really likes drains. But if you are going to use them because you need to, I think it’s nice to see that there are advances being made in this space to make things technologically advanced and easier to use.”

Dr. Janis, who has no conflicts of interest in this area, says Ohio State might use the SOMAVAC 100 eventually but, for now, he uses standard technology applying the best evidence practices.