Tube Fixation Research Articles

Design and application of small-diameter closed thoracic drainage tube fixation following lung wedge resection: A randomised prospective study.

The use of indwelling closed thoracic drainage tubes in the wedge resection of the lungs is of great significance to postoperative recovery. However, there are potential risks. To explore the design feasibility and application effect of triple-buffer-system-fixed small-diameter (18 F) thoracic closed drainage tubes following lung wedge resection. A total of 136 patients with indwelling thoracic drainage tubes following pulmonary wedge resection were recruited, with 70 patients allocated to the control group and 66 to the experimental group. The drainage tube in the experimental group was fixed with the triple-buffer system, while that in the control group was fixed using the conventional lifting platform method. The incidence of unplanned extubation, the indwelling time of the drainage tube and the time and material costs, as well as information regarding any subcutaneous emphysema and skin tension blisters, were recorded following the operation. The pain and degree of comfort were assessed using a chi-square test and a rank sum t-test to compare the differences between the two groups. There were no statistically significant differences in terms of age, gender and sweating between the two groups. Compared with the control group, the unplanned extubation rate of the experimental group was lower (χ2= 8.513; P= 0.004), the indwelling time of the drainage tube was shorter (t= 2.108; P= 0.037), the cumulative material cost was lower (t= 3.778; P< 0.001), the time cost was also lower (Z= 2.717; P= 0.008), the degree of comfort was higher (Z= 2.752; P= 0.006), and the degree of pain was lower (Z= 4.019; P< 0.001). The incidence of subcutaneous emphysema was significantly lower in the experimental group than in the control group (χ2= 8.513; P= 0.004). The use of the triple-buffer system to fix small-diameter (18 F) thoracic closed drainage tubes can reduce the unplanned extubation rate, indwelling time of the drainage tube and the incidence of adverse reactions.

Efficacy of Fixing Chest Tube to Chest Wall from Both Sides versus Single Side Fixation with Silk One Breaded Suture

Efficacy of Fixing Chest Tube to Chest Wall from Both Sides versus Single Side Fixation with Silk One Breaded Suture

A new abdominal drainage tube fixation method for 3-port laparoscopic cholecystectomy improves patients’ postoperative quality of life

ObjectiveLaparoscopic surgery has become a routine general surgery with many advantages, such as alleviating abdominal pain. However, postoperative pain caused by abdominal drainage tubes has attracted little attention from medical staff. The aim of this study was to explore the influence of a new abdominal drainage tube fixation method for 3-port laparoscopic cholecystectomy (LC) on patients’ postoperative quality of life. MethodsPatients who underwent 3-port LC with abdominal drainage tubes in the Department of Hepatobiliary Surgery of Linyi People’s Hospital from March 1, 2023 to October 31, 2023 due to gallstones with chronic cholecystitis were selected for this study. The patients were randomly divided into an experimental group and a control group. In the experimental group, the new abdominal drainage tube fixation method was used, while in the control group, the traditional method was used. Afterward, the quality of life of patient in terms of pain, activity, recovery time, and mental health status was evaluated. The exudate around the patient’s drainage tube was collected for bacterial culture and analysis. ResultsA total of 139 patients were randomly divided into an experimental group (70 patients) and a control group (69 patients). The patients’ baseline characteristics were not significantly different. The patients in the experimental group had better outcomes in quality of life, with higher pain scores (24.03 ± 2.37 vs. 15.48 ± 2.29, p < 0.001) and activity scores (20.57 ± 1.78 vs. 14.13 ± 1.43, p < 0.001), and a shorter postoperative recovery time (2.36 ± 0.68 d vs. 2.96 ± 1.34 d, p < 0.001). The same results were shown in linear regression analysis scores of the 2 groups. The positive rate of bacterial culture in the exudate around the patient’s drainage tube in the experimental group was significantly lower than that in the control group (12.9% vs. 43.5%, p < 0.001); and furthermore, the positive rate of conditional pathogenic bacteria was even lower (7.1% vs. 33.3%, p < 0.001) in the experimental group than in the control group. ConclusionThis new abdominal drainage tube fixation method can effectively promote patient rehabilitation and improve the quality of life for patient following 3-port LC with abdominal drainage tubes.

Prevention of Skin Damage Caused by Medical Adhesive Removal in Premature Infants

Objective: The aim of this study is to assess the effectiveness of the use of silicone tape and the use of a protective hydrocolloid dressing under silk tape in preventing skin damage due to medical adhesive removal in premature infants.&#x0D; Method: A randomized controlled trial was conducted with 75 premature infants between 32 and 36 weeks gestational age to examine the effects of the following medical adhesives used for fixing equipment on skin damage: protective hydrocolloid dressing + silk tape, silicone tape, and silk tape + silicone-based solvent spray. After medical adhesives were applied to the skin of the newborn for orogastric tube fixation, the skin condition was monitored for 24 hours. The skin condition was assessed with the Neonatal Skin Condition Scale before and after adhering to the medical adhesives. The statistical tool SPSS 22 was used to examine the study's data.&#x0D; Results: Neonatal skin condition scores were highest in the silk tape + silicone-based solvent spray group, while the lowest score was found in the silicone tape group. A statistically significant, moderate correlation, with a negative direction, was found between birth weight and post-application skin condition scores (r = -.432, p

Effect of a self-developed fixation device on preventing endotracheal intubation-related pressure injury: a randomised controlled trial

ObjectiveTo evaluate the effects of our self-developed endotracheal tube fixation device in mechanically ventilated patients.MethodsIn a dual-centre randomised controlled trial, patients who were expected to require mechanical ventilation for over 48 h were assigned to the observation group (using self-developed device) or the control group (using the traditional device). The primary endpoint was the incidence of endotracheal intubation-related pressure injury (EIRPI).ResultsFifty-one patients in the observation group and 54 patients in the control group were analysed. The incidence of EIRPI was 7.8% in the observation group and 33.3% in the control group (p = 0.001). Lip pressure injury (PI) occurred in 0 versus 14 (25.9%) patients in the observation versus control groups (p < 0.001). Both oral–mucosal and facial PIs were similar between the two groups.ConclusionsThe use of the novel device reduced the incidence of EIRPI, especially lip PI.Trial registration Chinese Clinical Trial Registry ChiCTR2300078132. Registered on 29 November 2023

Advanced Orotracheal Tube Fixation Techniques in Severe Burn Patients: Innovations from a Chilean Hospital

Since its foundation, the Hospital Emergency Public Assistance in Santiago, Chile, has been the national reference center for managing severe burn patients. In 2007, more than 6,000 hospital admissions for burns were registered in Chile due to the severity of the clinical condition. These patients must be treated in intensive care units. Therefore, the use of orotracheal tubes is essential for its management. The correct stabilization of these devices avoids complications or airway risks. In the Major Burn Unit, cotton cloth restraints and transpore-type adhesives are used on the user's face, but in patients with facial territory compromise, these cause tissue damage; due to this, the Dental Unit has innovative techniques of orotracheal tube fixation, using stainless steel and plastic wire ties, which have allowed to reduce the risks of extubation and accidental displacement of the tube, improving its stability. This work describes the technique used in orotracheal tube fixation in two patients with severe burns, performed by the Dental Unit of the Hospital Emergency Public Assistance, Dr. Alejandro del Río, Chile.

Avaliação dos métodos de fixação de sonda nasogástrica: adesão, deslocamento e integridade da pele

Objective: to evaluate three methods of nasogastric tube fixation in terms of adhesion, displacement and skin integrity. Method: ex vivo study, with a sample of 30 experimental noses (10 for each type of fixation), developed with porcine skin, based on the average measurements of the human nose, in which 14-gauge polyvinyl chloride probes were inserted and 2 methods of fixation with adhesive tape (Fixation A and B) and one with an industrial device (Fixation C) were used. Each group was exposed to traction of 50, 100 and 500g sequentially over 12 and 24 hours, testing: adhesion capacity, probe displacement and skin integrity. The Chi-square test of independence was calculated for nominal variables and Student’s t-tests and analysis of variance (p&lt; 0.05) for rational variables. Results: fixation B showed lower adhesion capacity (p &lt;0.001) when compared to the other two fixations. A mean displacement of 52.17 mm was observed in the probes fixed by methods A and B and a greater occurrence of lesions associated with fixations A and C (p = 0.001). Conclusion: the results show complications related to the fixations: lack of adhesion, displacement of the probe and skin lesions, drawing attention to the complexity of the procedure.

Research Progress on Modified Sengstaken-Blakemore Tube Fixation and Insertion Method for the Treatment of Rupture and Bleeding of Esophagogastric Varices

Research Progress on Modified Sengstaken-Blakemore Tube Fixation and Insertion Method for the Treatment of Rupture and Bleeding of Esophagogastric Varices

Positional relationships between a tracheal diverticulum and the tracheal tube under general anesthesia: a single-center observational and simulation study

BackgroundIncomplete sealing of tracheal diverticula by a tracheal tube cuff during positive-pressure ventilation causes barotrauma but the concrete possibility of incomplete sealing has not been indicated.We aimed to assess the possibility of incomplete sealing in a simulated situation of tracheal intubation for patients with tracheal diverticula with tube fixation where the tracheal tube’s vocal cord guide overlaps with the patient’s vocal cord.MethodsWe retrospectively assessed the characteristics of tracheal diverticula based on thoracic computed tomography data in our institution from January 2018 to July 2020. Then, we assessed the structural parameters of three single-lumen tracheal tubes (Parker Flex-Tip [Parker Medical, Bridgewater, CT, USA], Portex Soft Seal [ICU Medical, San Clemente, CA, USA], and Shiley TaperGuard [Medtronic, Dublin, Ireland]; 6.0–8.0 mm inner diameter size) and simulated the positional relationships between tracheal diverticula and the tracheal tube during tracheal intubation where the vocal cord guide overlaps with the patient’s vocal cord. We assessed each tube product’s possibility of incompletely sealing tracheal diverticula and the possibility of unintended bronchial intubation.ResultsIn 5,854 patients, the prevalence of tracheal diverticula was 5.7%. The mean (SD) length from the vocal cord to the distal end of the tracheal diverticula was 52.2 (12.8) mm. Tracheal tubes with length from the distal end of the tracheal cuff to the vocal cord guide of ≥ 70 mm had a low risk of incompletely sealing tracheal diverticula (< 5%) and length from the distal end of the tube to the vocal cord guide of ≤ 95 mm had a low risk of unintended bronchial intubation (< 5%). No products in this study satisfied both outcomes.ConclusionsTube fixation, where the vocal cord guide overlaps with the patient’s vocal cord, is associated with risk of incompletely sealing of tracheal diverticula depending on the tube’s manufacturer and tube’s inner diameter size, although it was not a high risk. The use of small inner diameter sized tube relative to patient’s body size is high risk of incomplete sealing of tracheal diverticula.Trial registrationThis trial was prospectively registered at University Hospital Medical Information Network (UMIN). Clinical trial number and registry URL: UMIN000043317 (URL: https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000048055).

Laparoscopic Techniques in Treatment of Inguinal Hernia in Patients with Peritoneal Dialysis: Experiences from 15 Cases.

Objective: This study aimed to investigate the feasibility, efficacy, and safety of laparoscopic transabdominal preperitoneal (TAPP) repair in the treatment of inguinal hernia in patients on peritoneal dialysis, and the optimal timing for initiating postoperative peritoneal dialysis. Methods: We conducted a retrospective analysis of the clinical data pertaining to patients on peritoneal dialysis with inguinal hernias treated with TAPP repair in the First Affiliated Hospital of Shandong First Medical University from July 15, 2020 to December 15, 2022. Follow-up observations of the treatment effect were also analyzed. Results: A total of 15 patients underwent TAPP repair with success. Contralateral occult hernias were found in 3 cases intraoperatively and were treated simultaneously. During the operation, it was found that the peritoneal dialysis tube was completely wrapped in the omentum majus in 1 case and incompletely wrapped in 5 cases and was separated smoothly under laparoscopy. Conclusion: For patients on peritoneal dialysis with inguinal hernia, TAPP repair has the advantages of less trauma, simultaneous treatment of contralateral occult hernias, adjustment and fixation of peritoneal dialysis tubes, lower incision complication rates, and lower recurrence rates, compared with open surgery. With the gradual resumption of peritoneal dialysis 7 days postoperatively, TAPP repair can be performed safely and effectively in this population group; thus it is a procedure worth promoting.

The "Tube Submarine Technique": a safe and easy technique to place an external drainage tube during hepaticojejunostomy in minimally invasive surgery.

Pancreaticoduodenectomy (PD) is a standard procedure for various pancreatic head lesions. Recently, minimally invasive surgery (MIS), including laparoscopic PD (LPD) or robotic PD (RPD), has been widely performed. The hepaticojejunostomy (HJ) technique in MIS is more difficult than that in open procedures, and the placement of an external drainage tube (EDT) is not common in MIS owing to its complicated procedure. Here, we demonstrate the "Tube Submarine Technique" (TST) to facilitate EDT placement without hampering the anastomotic maneuver in MIS. After resection of the MIS-PD, the jejunal stump was extracted from the umbilical incision, and a small jejunostomy was performed. A retrograde insertion of the EDT was carried out from this hole towards the jejunal stump. A 4-0 suture was applied through the tip and neighboring side hole, and ligated with a margin of approximately 1-2cm without needle release. The needle was passed through the anterior jejunal limb wall from the inside to the outside, and the tube was placed into the jejunal limb like a submarine and fixed to the anterior inside wall. After posterior wall suturing during HJ in MIS, the tube-fixing suture was cut immediately below the knot, the tube-like surface of the submarine was pulled up from the jejunal hole and inserted into the bile duct. The procedure of tube fixation inside the jejunal limb and tube surfacing was safe and easy with no complications. The TST can significantly help in the placement of an EDT in MIS.

Quality improvement project to reduce unplanned extubations in a paediatric intensive care unit.

Unplanned extubations are recurrent adverse events in mechanically ventilated children and have been the focus of quality and safety improvement in paediatric intensive care units (ICUs). To reduce the rate of unplanned extubation in the paediatric ICU by 66% (from 2.02 to 0.7). This is a quality improvement project that was conducted in a paediatric ICU of a private hospital at the quaternary level. All hospitalised patients who used invasive mechanical ventilation between October 2018 and August 2019 were included. The project was based on the Improvement Model methodology of the Institute for Healthcare Improvement to implement change strategies. The main ideas of change were innovation in the endotracheal tube fixation model, evaluation of the endotracheal tube positioning, good practices of physical restraint, sedation monitoring, family education and engagement and checklist for prevention of unplanned extubation, with Plan-Do-Study-Act, the tool chosen to test and implement ideas for change. The actions reduced the unplanned extubation rate to zero in our institution and sustained this result for a period of 2 years, totalling 743 days without any event. An estimate was made comparing cases with unplanned extubation and controls without the occurrence of this adverse event, which resulted in savings of R$955 096.65 (US$179 540.41) during the 2 years after the implementation of the improvement actions. The improvement project conducted in the 11-month period reduced the unplanned extubation rate to zero in our institution and sustained this result for a period of 743 days. Adherence to the new fixation model and the creation of a new restrictor model, which enabled the implementation of good practices of physical restraint were the ideas of change that had the greatest impact in achieving this result.

Prevention of Hospital-Acquired Transnasal Tube-Related Pressure Injuries: A Quality Improvement Project

Background. Nurses certified in wound, ostomy, and continence (WOC) monitored an increasing incidence of hospital-acquired transnasal tube-related pressure injuries (TTPIs) in a tertiary hospital. Hospital-acquired pressure injuries are one of the most common preventable complications of hospitalization; however, the significance of TTPI prevention must be considered alongside the safety of tube fixation to prevent unplanned extubations (UEs), which are serious adverse events. Thus, exploring a quality improvement (QI) project to effectively reduce the risk of TTPIs while safeguarding tube safety is urgently needed. Purpose. To decrease the incidence of TTPIs. Methods. Inpatients from 2017 to 2018 were set as the control group, using routine precautions. Inpatients from 2019 to 2020 were set as the experimental group, and a bundle of training and clinical practice interventions was implemented to compare the incidence of TTPIs and UEs between the 2 groups. Results. After improvement, the incidence of TTPIs reduced from 1.20% to 0.69%, the incidence of UEs reduced from 2.40% to 1.63%, and the differences were both statistically significant (P &lt; .05). Conclusion. The QI project reduced the incidence of TTPIs and UEs, thereby protecting the nasal skin/mucosal surfaces, safeguarding tube fixation, and ultimately improving the quality of clinical care.

Nurses' knowledge, Practice and Attitude regarding Endotracheal Tube Fixation: An Assessment Study

Nurses' knowledge, Practice and Attitude regarding Endotracheal Tube Fixation: An Assessment Study

Acute gastric twist after laparoscopic sleeve gastrectomy: A case series.

Laparoscopic sleeve gastrectomy (LSG) has become the most performed bariatric procedure. Like any surgical intervention, LSG is not free from complications. One of the rarest complications is gastric sleeve stenosis, caused by either stricture or axial rotation of the stomach (twisted gastric tube). There is no consensus on the management of such a complication due to several underlying mechanisms and different timings of presentation. Between July 1, 2021 and December 31, 2021, we encountered three cases of acute gastric twist following LSG, and all of them required surgical intervention. All data (imaging results, operative reports and videos, discharge summaries, etc.) were retrospectively collected and analyzed after obtaining patients' informed consent. We report three cases of acute gastric twist post-sleeve gastrectomy, diagnosed by different imaging modalities which showed localized distal gastric twist. All patients underwent exploratory laparoscopy which confirmed gastric sleeve twist. Gastropexy by fixation of the gastric tube to the transverse mesocolon was done in the first case which presented a localized partial distal twist, and a gastro-jejunal anastomosis proximal to the gastric twist was performed in the two other cases to bypass the obstruction. All of them had excellent postoperative results and a total symptomatic resolution. We considered gastric tube fixation to the transverse mesocolon as a feasible option when the twist is local and partial. We also presented a new surgical modality to treat local complete distal gastric twist by a single gastro-jejunal latero-lateral anastomosis proximal to the twist, which seems safe and effective. The best method to treat such a complication is to prevent it by giving special attention to the different technical aspects of LSG.

Study on the effect of "7" and "I" shaped adhesive tape in fixation of nasogastric tubes

Study on the effect of "7" and "I" shaped adhesive tape in fixation of nasogastric tubes

The Hitchhiker Position in Endoscopic Pituitary Surgery.

Technically and ergonomically correct positioning is essential in endoscopic transsphenoidal pituitary surgery. To propose a safe, ergonomic approach to conduct endoscopic endonasal pituitary and skull base surgery in large patients without sacrificing important aspects of current standard practice. The patient's right arm is outstretched and secured in a supine position, with the primary surgeon standing in the axillary area. Considerations include maintaining comfort, immobility, anesthesia access, endotracheal tube fixation, intravenous lines, thorax elevated 25° to 30° for optimization of respiration, free and exposed abdomen for fat graft, legs positioned with no sciatic stretch or venous strain, and the patient's head in parallel with the surrounding area to sustain a strict midline. Ten patients who underwent transsphenoidal pituitary tumor resections conducted using the hitchhiker position from October 2019 to June 2021 comprised our study cohort. The patients' mean height was 168.70 ± 9.29 cm, their mean weight was 114.35 ± 19.32 kg, and their mean body mass index was 40.19 ± 6.39 kg/m 2 . Twenty percent (n = 2) patients had a body mass index classified as "obesity class 1," 50% (n = 5) as "obesity class 2," and 30% (n = 3) as "extreme obesity class 3." The primary surgeon consistently reported decreased bodily strain and improved ergonomic access to the surgical site using the hitchhiker position. The hitchhiker position offers the opportunity to improve both patient and physician well-being in the context of endoscopic pituitary surgery.

The Hemostatic Effect of Modified Three-Cavity and Two-Cystic Tube Fixation Method and Its Effect on Patient's Comfort

Three-cavity two-cystic tube compression hemostasis was an effective treatment for the control of the bleeding of esophageal varices. However, as an invasive operation, three-cavity two-cystic tube caused a variety of adverse reactions. The present study summarized traditional three-cavity two-cystic tube fixation method and the hemostatic effect of the modified three-cavity two-cystic tube fixation method on the patient’s comfort. Compared to traditional one, it was found that the modified fixation method had ideal hemostatic effect in clinical application, and the patient’s comfort and acceptance were better, which was convenient to carry out and reflected the high quality level of nursing.

Effect of Nasal Wall Fixation with Nonabsorbable Sutures during Nasolacrimal Silicone Intubation in Adults

Purpose: We explored the effects of silicone tube fixation using a nonabsorbable suture on the adult nasal wall during silicone tube intubation.Methods: The medical records of patients (50; 54 eyes) diagnosed with nasolacrimal duct stenosis and canalicular lacerations who underwent silicone tube fixation to the nasal wall (using nonabsorbable sutures) during silicone tube intubation from January 2019 to June 2021 and who were followed-up for more than 3 months after surgery were retrospectively investigated. We recorded the percentages of early silicone tube displacement and noted other complications.Results: We enrolled 22 males and 28 females of average age 65.28 ± 8.88 years. The silicone tubes were maintained for an average of 9.13 ± 1.77 weeks in the nasolacrimal duct stenosis group and 20.13 ± 3.36 weeks in the canalicular laceration group. Early tube displacement occurred in two of 46 eyes (4.4%) in the nasolacrimal duct stenosis group and in 0 of eight eyes (0%) in the canalicular laceration group. Overall, early displacement occurred in only two of 54 eyes (3.7%). Other complications included nasal irritation in four cases (7.4%), canaliculitis in three (5.6%), and loss of fixed nonabsorbable sutures in three (5.6%).Conclusions: Silicone tube fixation to the nasal wall using a nonabsorbable suture during silicone tube intubation simply and effectively prevents early tube displacement and loss, associated with minimal complications.

Clinical Proof of Concept for Stabilization of Tracheostomy Tubes Using Novel DYNAtraq Device.

IntroductionTracheostomy is one of the most common surgical strategies in intensive care units (ICU) and provides relevant clinical benefit for multiple indications. However, the complications associated with its use range from 5 to 40% according to different series. The risk of these complications could be reduced if fixation strategies and alignment of the tracheostomy tube with respect to the tracheal axis are improved.AimTo build a functional device of technological innovation in respiratory medicine for the fixation and alignment of tracheostomy cannula (acronym DYNAtraq) and to evaluate its feasibility and safety in a pilot study in mechanically ventilated patients.MethodsStudy carried out in four phases: (1) design engineering and functional prototyping of the device; (2) study of cytotoxicity and tolerance to the force of traction and push; (3) pilot study of feasibility and safety of its use in tracheostomized and mechanically ventilated patients; and (4) health workers satisfaction study.ResultsThe design of the innovative DYNAtraq device included, on the one hand, a connector with very little additional dead space to be inserted between the cannula and the ventilation tubes, and, on the other hand, a shaft with two supports for adhesion to the skin of the thorax with very high tolerance (several kilograms) to pull and push. In patients, the device corrected the malpositioned tracheostomy tubes for the latero-lateral (p < 0.001) and cephalo-caudal angles (p < 0.001). Its effect was maintained throughout the follow-up time (p < 0.001). The use of DYNAtraq did not induce serious adverse events and showed a 70% protective effect for complications (RR = 0.3, p < 0.001) in patients.ConclusionDYNAtraq is a new device for respiratory medicine that allows the stabilization, alignment and fixation of tracheostomy tubes in mechanically ventilated patients. Its use provides additional benefits to traditional forms of support as it corrects misalignment and increases tolerance to habitual or forced movements. DYNAtraq is a safe element and can reduce the complications of tracheostomy tubes.