In my department there will be a change in the drains usually used after abdominal surgery from Robinson drains (tube drains) to easy flow drains (capillary drain).
Thank you for your answer! I have to confess, that I still have concerns with penrose/easyflow etc drain about the possible contamination with cytotoxic substances because of leckage of the dressing of this drains even if you use drainage bags. So I personally favor tube drains like Robinson drains even if they have their problems too. Did you see any problems? What think the people from ICU about your drains ? And how do you try to avoid spillage of cytotoxic substances from the kind of dressing you use?
we don't put dressings over the penrose, but small collecting bags (Biotrol) connected to a tube and collecting bag. Of course ICU and ward personnel are instructed to handle all body fluids as 'contaminated' for a period of 7 days.
Thank you again. We have small drain collecting bags from Coloplast (look like in ostomy care).. They can be connected to large volume collecting bags. But we often see leckage of this collecting system shortly after operations so a change of these bags is necessary..
I would appreciate the feedback and the opinions and experiences of all the other members of researchgate performing cytoreductive surgery and HIPEC.
Hello,
We remove the inflow tube (30 F) at day-2 and we use "drain de Blake Ethicon" connected to a drainobag. All body fluid are supposed to be contaminated. Up to date we faced no problem with this kind of drainage.
Dear Naoul,
thank you for your comment. What kind of Blake drains do you use? The flat or the round ones? And how many?
With Robinson drains I did not see any problems, either and so I am a little bit worried about changing a part of the regime that is without problems.
It has been our practice to use tube drains and connect them to a drainage bag.we prefer to remove the drain depending on the out put usually 5th or 7th day.No problems in managing the drain by the ccu nurses.
We use Robinson drains where required and do not see any problem
We had used round Blake drains with no major in the few cases of our group. By the way, have you apply mannitol and magnesium sulfate immediately before the administration of cisplatin in HIPEC procedures in order to force diuresis and decrease renal toxicities?
No, we do not use any specific medication before the HIPEC-procedure. During the first part of the operation - the cytoreduction - there are restrictions to fluid therapy. When we start to place the tubes for the hyperthermic perfusion and to close the skin of th abdomen, fluid is given more liberally and there is an increase in urine production. By managing the infusion regimen like this, we saw less edema after the HIPEC and on the other hand we had no problems with renal toxicity of cisplatin.
Hello, we use four major rigid thoracic drainages (28F) for Hipec perfusion. After the procedure the patient usually (but not always) get to the ICU where the personnel is aware of the possible minimal contamination. Minimal or even absent due to the fact that ,at the end of cytotoxic perfusion, we clear up the peritoneal cavity just to remove the residual drug inside. We do not routinely use Mannitol to prevent renal toxicity with Cisplatin that we didn't registered.