Improvising a surgical drain with an infusion giving set and an empty saline container: An improvised surgical technology case report

Abstract

Background: Improvisation is key to surmounting challenges of unavailability and prohibitive cost of surgical staff, stuff, space, and systems in Low- and Middle-Income Country contexts. We describe a step-by-step method for construction of an improvised surgical drain which has been used at our institution following thyroidectomies and mastectomies requiring drainage in a setting of resource constraints for over 20 years.

Patients: The drain has found use in surgical wound drainage following thyroidectomy, mastectomy, and laparotomy for patients with indications for drainage.

Intervention: In this surgical technology case report, we describe the 7-step process for fashioning and deploying this low-cost, low negative-pressure, closed tube surgical drain from an empty 500 mL normal saline collapsible plastic container, and an intravenous fluid giving set. The drain generates a calculated maximum opening negative pressure of 15.4 kPa calculated by Bernoulli equation and costs about 1.1 USD.

Conclusion: The technological simplicity of this low-cost improvised, negative pressure, closed tube drain for thyroid, breast, and abdominal surgeries in low resource settings constructed from a 500 mL infusion bag and an intravenous fluid giving set is apparent. The drain’s bio-mechanical efficiency and cost effectiveness must be validated against standard custom-made drains. Some randomised control studies are being carried out to that effect.