closed-wound suction, any one of several techniques for draining potentially harmful fluids, such as blood, pus, serosanguineous fluid, and tissue secretions, from surgical wounds. Such fluids interfere with wound healing and often promote infection. Postoperative drainage aids the healing process by removing dead spaces where extravascular fluids collect and helps draw healing tissues together. Closed-wound suction is often an important part of postoperative treatment and may be accomplished with a variety of reliable devices that create a gentle negative pressure to drain away undesirable exudates. The technique is used as an aid to many operations, such as mastectomies, breast augmentations, plastic and reconstructive procedures, and urological and urogenital procedures. It is generally used whenever the wound drainage is greater than 100 mL in 24 hours. Closed-wound suction devices usually consist of disposable transparent containers attached to suction tubes and portable suction pumps. ▪ METHOD: After thoroughly irrigating the wound to remove blood clots and debris, the surgeon inserts the perforated tubing into the wound and draws it out through healthy tissue, approximately 5 cm from the incision line. When silicone tubing is used, the tube is passed through a stab wound made adjacent to the surgical wound. With the drainage tubing emerging away from the incision line, the suction system remains completely closed. Air cannot infiltrate the wound and cause contamination. When the suction tube has been inserted, the wound is closed, and a light dressing is applied. Because the tubing drains most fluids, the dressing usually does not require frequent changing. Closed-wound suction usually continues postoperatively for 2 or 3 days or until the wound stops exuding fluid. Suction is much longer after mastectomies. The surgeon then removes the suction tubing, and all drainage components of the suction device are discarded. ▪ INTERVENTIONS: While the suction is functioning, the transparent tubing and reservoir are checked regularly as a precaution against clogging and for monitoring of the volume of exudate drawn from the wound. In some individuals, closed-wound suction systems can also accommodate antibiotic drips, which are connected to accessory tubing placed within the wound beside the suction tube. Closed-wound suction also allows irrigation of the wound with special flow controls to permit a periodic change in the flow direction of solutions.
