Bülau drainage is the insertion of a special tube through surgical incisions. This method is used by doctors after operating on the mediastinal organs. With the help of such treatment, the prevention of respiratory compression is carried out.
What is the purpose of the procedure?
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 - dressings and gloves;
- anesthetic syringe;
- scalpel;
- silk threads;
- scissors;
- needle holder.
You can't do without clamps, catheters, water.
Performing the procedure
The doctor implements drainage according to the principle of a siphon hood. To remove air, the device is fixed inupper region of the pleural cavity. If a massive empyema of the pleura is formed, then the tube will be placed below (from the 5th to the 7th intercostal convergence along the median axillary section).
During Bulau drainage, several settings are used. Several tubes need to be prepared. One of which supplies air, and the second - removes liquid substances.
With the help of this method, the internal cavity is washed and sterilized. During flushing, the doctor uses special liquid preparations. Before performing the procedure, the specialist performs a puncture of the pleura. With the help of such an analysis, it is possible to determine what substance the respiratory organs are filled with. Based on the result of the diagnosis, the appropriate treatment is prescribed.
In order to improve the he alth of the patient and normalize the functioning of the respiratory system, drainage is carried out according to Bulau.
Preparatory process
In the process of the procedure, the surgeon is assisted by his assistant. The patient needs to sit down on the dressing table, the feet should be placed on a special stand. On the one hand, a puncture will be carried out, and on the other hand, the patient rests on a chair with soft pads.
Using medical gloves and wearing a mask, the doctor injects anesthesia into 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 a sterile one. The needle should be inserted until it has completely passed through the intercostal tissue. The quality of theprocedure depends on the experience and qualifications of the doctor. In the process of carrying out the drainage of the pleural cavity according to Bulau, it is important to make a puncture in the right place, otherwise the artery may be damaged. It is necessary that the doctor check the cavity for the presence of air. Using a pressure gauge, the pressure is determined, which ideally is 0.99-1.4 kPa. With a proper indicator, the surgeon prepares the patient and instruments for drainage.
Sequence of actions
Bülau drainage technique:
- The doctor draws liquid from the chamber with a syringe.
- Then he makes a small incision with a scalpel.
- Next, the trocar device is started. After insertion, the doctor pulls out the stylet and inserts the tube into the trocar sleeve. At the other end, the catheter should be pinched to prevent air from entering through it. It is very important to perform all actions as quickly as possible so that air does not enter the pleural chamber. All instruments must be sterilized and at hand.
- After inserting the catheter into the surrounding tissues, the surgeon applies a U-shaped suture, this will ensure tightness at the insertion site. After that, you need to slowly withdraw the tube.
- It is important to hold the phone in order to keep the position. If a liquid substance appears in the catheter, this is a sign of a correctly performed procedure.
- Doctor attaches suction units. With the help of electric suction and other devices, the procedure is carried out. Using plastic tape, all connectionsfix.
- Due to Bulau drainage, the necessary pressure is maintained inside the pleural cavity. In the event that the analgesic effect ends, anesthesia should be reintroduced. Stitches should be loosened but not completely removed.
The patient needs to hold their breath while the drain is being withdrawn. With the help of loose sutures, the specialist tightens the affected area and applies fixing bandages.
Under what circumstances is the procedure indicated?
Quite often, doctors perform Bulau drainage with pneumothorax. Manipulation must be carried out if air or fluid has accumulated in the pleural cavity, which is presented as:
- blood;
- lymph;
- pus.
Fluid may appear due to a running inflammatory process or injury to the chest. The procedure helps to restore the patient's he alth 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 clotting often causes heavy bleeding during drainage.
Diagnosis of the patient's condition
If a patient has a hemothorax, hydrothorax or purulent pleurisy, indrainage is mandatory. To determine whether there is fluid or air in the pleural cavity, a thorough medical diagnosis is necessary. Ultrasound and radiography are mandatory.
What research methods does the doctor prescribe?
Draining after lung surgery will prevent severe inflammation. Sometimes, with advanced acute illness, patients need emergency help. Thanks to the drainage of the pleural cavity, it is possible to restore the full functioning of the respiratory system. In chronic illness, the procedure is carried out from time to time in order to remove all accumulated fluid.
Proper manipulation technique will save the patient's life. Improper drainage may result in death of the patient. For this reason, this procedure should only be carried out by an experienced and qualified medical professional.
Features of the Bulau method
Bülau's pleural cavity drainage technique is to insert a device through the costophrenic sinus and then remove air with fluid. Thanks to this method, blood, lymph and pus can be removed. During the procedure, it is important to create negative pressure. Most often, this method of therapy is used if there is a strong inflammatory process. The least common use by medical professionals is passive Bülau drainage, as the fluid is removedsignificantly longer.
What are the complications?
If the doctor is not experienced enough, serious he alth problems may occur after draining. Many factors can provoke complications, namely:
- blood disease;
- bleeding tendency;
- severe pain shock (due to the introduction of an insufficient dose of pain medication);
- large body fat;
- thick layer of fibrous tissue of the pleura.
If you neglect the doctor's recommendations, the incision site where the drainage was located can become very inflamed, as a result of which the seams diverge. For this reason, it is important to avoid physical activity and not carry heavy weights after surgery.
Among the most serious complications are:
- damage to a large vessel, as well as internal organs;
- infectious disease;
- blockage of drainage device;
- hemorrhage profusely.
If there is pain at the incision site, you should immediately inform your doctor. To prevent the development of an infectious disease, it is important to properly handle the seams.
Note to patient
To prevent the occurrence 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 exacerbate the problem. It is forbidden to use alternative methods of therapy. Drainage of the pleural cavity should be carried out onlya licensed medical professional with extensive experience, since the slightest mistake on the part of the one who performs this procedure can lead to the development of serious complications or even death.
