Bulau drainage is the introduction of a special tube through surgical incisions. This method is used by doctors after operating the mediastinal organs. With the help of such treatment, prevention of compression of the respiratory system is carried out.
What are the procedures for?
Doctors perform Bulau drainage to remove various secretions from the lungs. Used in the treatment of serious diseases of the internal organs of the chest. In the course of surgery, the specialist uses:
- sterile products - dressing and gloves;
- syringe with anesthesia;
- scalpel;
- silk threads;
- scissors;
- device for fixing the needle.
Do not do without clamps, catheters, water.
The implementation of the procedure
The doctor implements drainage on the principle of siphon extraction. To remove air, the device is fixed in the upper region of the pleural cavity. If a massive pleural empyema forms, then the tube will be placed below (from the 5th to the 7th intercostal convergence along the median axillary section).
In the process of drainage according to Bulau, several installations are used. It is necessary to prepare several tubes. One of which delivers air, and the second - removes liquid substances.
Using this method, washing and sterilization of the internal cavity is carried out. During flushing, the doctor uses special liquid preparations. Before performing the procedure, the specialist conducts a pleural puncture. Using this analysis, you can determine what substance is filled with the respiratory system. Based on the diagnostic result obtained, appropriate treatment is prescribed.
In order to improve the patient’s health and normalize the functioning of the respiratory system, Bulau drainage is performed.
Preparatory process
During the procedure, the surgeon is assisted by his assistant. The patient needs to sit on the dressing table, the feet should be placed on a special stand. On the one hand, puncture will be performed, and on the other, the patient rests on a chair with soft linings.
Using medical gloves and putting on a mask, the doctor administers anesthesia to the patient and treats the skin in the place where the Bulau cavity will be drained. After the introduction of anesthesia, the specialist changes the needle to sterile. The needle should be inserted until it passes completely through the intercostal tissue. The quality of the procedure depends on the experience and qualifications of the doctor. In the process of draining the pleural cavity according to Byulau, it is important to puncture in the right place, otherwise you can damage the artery. It is necessary that the doctor check the cavity for air. Using a manometer, a pressure is determined, which ideally is 0.99-1.4 kPa. With a proper indicator, the surgeon prepares the patient and instruments for drainage.
Sequencing
Bulau Drainage Technique:
- A doctor draws fluid from the chamber with a syringe.
- Then carries out a small incision with a scalpel.
- Next, the adaptation of the trocar starts. After the introduction, the doctor draws out the stylet and launches the tube into the sleeve of the trocar. At the other end, the catheter should be pinched so that air does not enter through it. It is very important to perform all actions as quickly as possible so that air does not enter the pleura chamber. All instruments must be sterilized and at hand.
- After the catheter is inserted, the surgeon places a u-shaped suture on the surrounding tissue, this will ensure tightness at the insertion site. After which it is necessary to slowly withdraw the tube.
- It is important to hold the handset in order to maintain position. If a liquid substance appears in the catheter, this is a sign of a correctly performed procedure.
- The doctor attaches the suction unit. Using electric suction and other devices, the procedure is carried out. Using plastic tape, all connections are fixed.
- Thanks to Bulau drainage, the necessary pressure is maintained inside the pleural cavity. In the event that the analgesic effect ends, anesthesia should be repeated. The seams must be loosened, but not completely removed.
The patient needs to hold his breath while draining. With the help of weakened seams, the specialist tightens the area of influence and imposes fixing bandages.
Under what circumstances is the procedure indicated?
Quite often, doctors carry out Bulau drainage with pneumothorax. Manipulation must be carried out if air or fluid has accumulated in the pleural cavity, which is presented in the form:
Liquid may appear due to a running inflammatory process or trauma to the chest. Carrying out the procedure helps to restore the patient’s health and alleviate the unpleasant symptoms of the disease.
Contraindications to the procedure
The doctor determines the indications and contraindications for drainage only after a thorough medical examination of the patient. The procedure is not recommended for blood diseases. Poor blood coagulation often causes severe bleeding during drainage.
Diagnosis of the patient
If the patient has hemothorax, hydrothorax or purulent pleurisy, drainage is mandatory. A thorough medical diagnosis is necessary to determine if fluid or air is present in the pleural cavity. Ultrasound and radiography are mandatory.
What research methods does the doctor prescribe?
Drainage after surgery in the lung area will prevent severe inflammation. Sometimes, with an acute illness, patients need emergency assistance. Thanks to the drainage of the pleural cavity, the full functioning of the respiratory system can be restored. In chronic illness, the procedure is carried out from time to time in order to remove all accumulated fluid.
The correct manipulation technique will help save the patient's life. If the drainage is not carried out correctly, death of the patient is possible. For this reason, such a procedure should be carried out exclusively by an experienced and qualified medical professional.
Features of the application of the method according to Bulau
The technique for draining the pleural cavity according to Byulau is to introduce the device through the costal-diaphragmatic sinus and then remove air with fluid. Thanks to this method, you can remove blood, lymph and pus. In the process, it is important to create negative pressure. Most often, this method of therapy is used if a strong inflammatory process is present. Less often, medical personnel use passive drainage according to the Bulau, since the fluid is discharged much longer.
What can be the complications?
If the doctor is not experienced enough, serious health problems can occur after drainage. Many factors can trigger complications, namely:
- blood disease
- tendency to bleeding;
- severe pain shock (due to the introduction of an insufficient dose of an anesthetic drug);
- a large fat layer;
- a thick layer of pleural fibrous tissue.
If you neglect the doctor’s recommendations, then the incision site where the drainage was can become very inflamed, as a result of which the seams diverge. For this reason, it is important to avoid physical activity and not to carry heaviness after surgery.
Among the most serious complications are:
- damage to a large vessel, as well as internal organs;
- infection;
- blockage of the drainage device;
- profuse hemorrhage.
If painful sensations are present at the incision site, the doctor should be urgently informed. In order to prevent the development of an infectious disease, it is important to properly process the stitches.
Note to patient
To prevent the appearance of pathology, it is important to regularly visit a doctor and take all the tests prescribed by him. If one of the signs of the disease appears, you should immediately go to the hospital. Self-medication in this situation can only harm and aggravate the problem. It is forbidden to use alternative methods of therapy. Drainage of the pleural cavity should be carried out only by a certified medical professional with extensive experience, since the slightest mistake on the part of the person who is carrying out this procedure can lead to the development of serious complications or even death.