INTRODUCTION: A major factor affecting patients' length of hospitalisation following head and neck surgery remains the use of surgical drains. The optimal time to remove these drains has not been well defined. A routine practice is to measure the drainage every 24 h and remove the drain when daily drainage falls below 25 ml. This study aims to determine whether drainage measurement at shorter intervals decreases the time to drain removal and hence the length of in-patient stays. PATIENTS AND METHODS: A 6-month prospective observational study was performed. The inclusion criteria were patients who underwent head and neck surgery without neck dissection and had a closed suction drain inserted. Drainage rates were measured at 8-hourly intervals. Drains were removed when drainage-rate was = 1 ml/h over an 8-h period. RESULTS: A total of 43 patients were evaluated. The highest drainage rate occurred in the first 8 postoperative hours and decreased significantly in the subsequent hours. The median drainage rates at 8, 16, 24, 32 and 40 postoperative hours were 3.375, 1, 0, 0 and 0 ml/h, respectively. Applying our new removal criteria of = 1 ml/h drainage rate, the drains were removed in 22 (51%) patients at the 16th postoperative hour; 37 (86%) were removed by 24 h after operation. In comparison, only nine (20.9%) patients could potentially be discharged the day after surgery if previous criteria of = 25 ml/24-h were used to decide on drain removal. CONCLUSIONS: Our 8-hourly drainage-rate monitoring has facilitated safe earlier discharge of an additional 28 (65%) patients on the day after surgery. This has led to improvement in patient care, better optimisation of hospital resources and resulted in positive economic implications to the department.
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机译:简介:影响患者头颈部手术后住院时间的主要因素仍然是使用引流管。清除这些排水口的最佳时间尚未确定。常规做法是每24小时测量一次排水量,当每日排水量低于25 ml时,应清除排水。这项研究的目的是确定以较短的时间间隔进行引流测量是否会减少引流清除的时间,从而减少住院时间。患者与方法:进行了为期6个月的前瞻性观察研究。纳入标准为未经头部解剖而接受头颈手术且插入闭合引流管的患者。每8小时测量一次排水率。当排水速率在8小时内 = 1 ml / h时,将排水管移除。结果:共评估43例患者。最高的引流率发生在术后的前8小时,随后的几个小时显着下降。术后8、16、24、32和40小时的中位引流率分别为3.375、1、0、0和0 ml / h。采用我们新的排水速率 = 1 ml / h的去除标准,术后16小时的22例患者(51%)去除了引流管。手术后24小时去除了37例(86%)。相比之下,如果使用先前的25ml / 24h的标准来决定引流的去除率,那么只有9名(20.9%)的患者可能在手术后第二天出院。结论:我们的8小时引流速率监测有助于在术后第二天安全地早吐出另外28名(65%)患者。这改善了病人的护理,更好地优化了医院资源,并对部门产生了积极的经济影响。
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