Choice and management of negative pressure drainage in anterior cervical surgery

World J Clin Cases. 2020 Jun 6;8(11):2201-2209. doi: 10.12998/wjcc.v8.i11.2201.

Abstract

Background: Postoperative unobstructed drainage is an important measure for avoiding hematoma formation and preventing complications from anterior cervical surgery.

Aim: To discuss the characteristics and key points of clinical management of two types of commonly used negative pressure drainage systems in clinical settings.

Methods: Two types of commonly used silica gel negative pressure drainage balls and a type of gastrointestinal decompression apparatus were fully emptied and then injected with different amounts of water and air. Following this, the negative pressure values of the three devices were measured. Meanwhile, we undertook a retrospective analysis of the clinical data of 1328 patients who had been treated with different negative pressure drainage apparatuses during their anterior cervical surgery in our department between January 2007 and January 2018.

Results: As the amount of injected air or water increased, the negative pressure of the silica gel negative pressure drainage ball decreased rapidly, dropping to zero when 150 mL of water or air was injected. In contrast, the negative pressure of gastrointestinal decompression apparatus decreased slowly, maintaining an ideal value even when 300 mL of water or air was injected. And statistical analysis demonstrated that patients who had been treated with the gastrointestinal decompression apparatus were less likely to develop severe complications than those who had been treated with the silica gel negative pressure drainage ball (P < 0.05).

Conclusion: This study showed that the gastrointestinal decompression apparatus has the advantages of large suction capacity, long duration of continuous negative pressure, and good drainage effect, all of which are the favorable factors for the use of this apparatus for negative pressure drainage in anterior cervical surgery.

Keywords: Anterior cervical surgery; Drainage; Gastrointestinal decompression apparatus; Negative pressure; Silica gel negative pressure drainage ball; Spine.