In a percentage of patients who undergo surgery and have drains sited, a number of complications involving their drains may slow clinical progress. Drains may become displaced - or either completely or partially withdrawn - and therefore can become ineffective.
These patients will have to undergo another procedure - possibly under anaesthesia - to replace the drain. This involves senior medical staff and can be problematic, having the potential to prolong patients’ hospitalisation, or prolong the time spent in an ICU (Intensive Care Unit) bed. Any one of these options poses a costly solution.
Traditionally, drains are held in place by tape and suture. If drains secured by conventional methods require adjustment, the original fixation will require replacement and furthermore the removal of a drain will require tape to be removed and anchoring sutures to be excavated from their position in the skin.
Securement by tape contributes to potential skin damage, can obscure the wound site and may even mask a drain that has migrated completely from its internal position leaving it positioned under the tape dressing and on top of the skin, rendering it useless.
The best initial judgement of tube position is made by external review (an x-ray is normally required to establish the exact position of drains in situ and to monitor improvements in any pathology). A drain which has moved position or has come out completely may be masked by any covering dressings and may not be discovered until the dressings are removed.
The time which passes during this period is frequently unrecorded, but anecdotally it is a period of many - often critical - minutes. If a drain becomes displaced unknowingly, a considerable amount of valuable clinical time may have elapsed before an effective clinical decision has been made and can become the cause of most access-related complications: infiltration, phlebitis, occlusia. Furthermore any adjustments to malposition / removal of drains previously sited normally involves another medical procedure.
Different surgeons appear to prefer different methods to attach drains and there do appear to be different problems with the use of the various methods, with no real, quick and easy procedure. We have identified that there was certainly an unmet clinical need for a standard method of securement that could be quick and simple to use and would ensure securement without the problems previously encountered.
Based on the principle of the "Chinese finger trap", we have developed a device to address drain securement problems. This device is made from a polyester braided construction that is put over the drain, or any other tube that needs to be inserted. It holds the drain in place without being able to slide and provides an unobstructed view of the wound site at the point of entry whilst allowing for easy adjustment and easy removal of the whole set. It is latex-free and minimises damage to the skin and general patient discomfort.
A recent study at Great Ormond Street Hospital (GOSH), London, UK found that in 96% of cases, the device was "easily installed" and lasted on average 2.4 days each until they were removed under planned and controlled circumstances. There were no complications as a result of using the BRAIDLOCK® device.
