The use of ultrasound to locate a tethered surgical drain: a novel way to achieve fast removal
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The use of ultrasound to locate a tethered surgical drain: a novel way to achieve fast removal Hui Li1, Yan Du2, Jia‑bin Wu3, Pan Wang3, Jun Yang1, Ping Hu1 and Tao Ai1*
Abstract Background: 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. Methods: 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 loos‑ ened through a small incision, and the drain was completely removed. Results: 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. Conclusions: 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. Keywords: Ultrasound, Tethered drain, Sutured, Sliding sign, Complications Background Although it is rare that drains cannot be removed after orthopedic surgery, this situation cannot be completely avoided. The main reason for a tethered drain is inadvertent suture fixation during the closure of an incision, and other reasons include the incarceration of soft tissue, local compression, folding, etc. [1, 2]. Several methods can be employed to remove a drain, including continuous traction, rotation, and cutting inside and outside the lumen by using various instruments [3–5]. The *Correspondence: [email protected] 1 Department of Traumatology, Chongqing Emergency Medical Center, Chongqing University Central Hospital, 1 Jiankang Road, Yuzhong District, Chongqing 400014, China Full list of author information is available at the end of the article
above methods have been shown to be partially effective. However, when the fixed point of the drain cannot be determined, the operation may require a long period of time. Repeated attempts can also damage the drain and soft tissues [6]. As a result, the risk of wound infection is increased. Reopening the incision and extricating the drain require the patient to return to the operating room and may lead to medical disputes, but this is also the safest and most effective method. If the incision is large, searching for the sutured site without a good plan will cause unnecessary damage to the soft tissue. Locating the sutured point of the tube by experience is often unreliable. We report a method using
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