The use of ultrasound to locate a tethered surgical drain: a novel way to achieve fast removal

• Published in: BMC surgery Vol. 20; no. 1; p. 264
• Main Authors: Li, Hui, Du, Yan, Wu, Jia-Bin, Wang, Pan, Yang, Jun, Hu, Ping, Ai, Tao
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 31.10.2020; BioMed Central; BMC
• Subjects: Adult; Anesthesia; Animals; Antibiotics; Bone surgery; Complications; Device Removal - methods; Drainage (Surgical); Drainage - instrumentation; Female; Foreign Bodies - diagnostic imaging; Foreign Bodies - etiology; Foreign Bodies - surgery; Humans; Infections; Intravenous administration; Male; Management; Medical tubing; Medical ultrasonics; Methods; Middle Aged; Models, Anatomic; Orthopedic Procedures - adverse effects; Orthopedic Procedures - methods; Orthopedic surgery; Orthopedics; Patients; Silicones; Sliding; Sliding sign; Soft tissues; Surgery; Suture Techniques - adverse effects; Sutured; Sutures; Sutures - adverse effects; Swine; Technical Advance; Tethered drain; Trauma; Ultrasonic imaging; Ultrasonography; Ultrasound; China; Tethered drain; Sutured; Sliding sign; Complications; Ultrasound
• ISSN: 1471-2482; 1471-2482
• DOI: 10.1186/s12893-020-00929-y

It is rare that drains cannot be removed after surgery, however, this situation cannot be completely avoided, and is also hard to deal with. The main reason for a tethered drain is inadvertent suture fixation. At present, no effective way was published or widely accepted to locate the tethered drain. Three cases of orthopedic trauma patients experienced unsuccessful removal of the drain after surgery. The ultrasound was used to locate the sutured site of the drain. Based on the sliding sign and vanishing point which can be detected by the ultrasound, the sutured site of the drain can be clearly identified. Finally, the suture was loosened through a small incision, and the drain was completely removed. The surgical procedure was very successful in all patients. The tethered drain was quickly and completely removed through a small incision with locating by ultrasound. Intravenous antibiotics were administered within 24 h after surgery, and no wound or deep infections occurred. Ultrasound can be used to locate a tethered drain based on the sliding sign. This method can simplify the release procedure and achieve fast removal of the drain. Furthermore, it will help lower the risk of a retained drain and soft tissue complications.