Eur J Plast Surg (2004) 27:46 DOI 10.1007/s00238-003-0581-y LE TT ER TO T H E E DITOR N. Sarifakioglu · G. Aslan · A. Terzioglu · F. Bingul Received: 25 August 2003 / Accepted: 3 November 2003 / Published online: 10 March 2004 Springer-Verlag 2004 Dear Sir, To diminish dead space after post-surgical closure, drains are often used in reconstructive, head and neck surgery. As rubber or vacuum silicone drains have a rigid struc- ture, they can be sutured easily. The defect occurring after the removal of the drain and its attachment frequently heals secondarily. In this situation, early revision or late- scar correction surgery are rarely required. Penrose drains of various sizes can be used when indicated. Since these drains have a fairly soft and slippery structure, they can be removed easily and this results in a temporary defect in the area where they have placed. As there is secondary healing of the drain site, scar revision may be required (especially in the parotid and facial areas). Although they stay in place better than rigid drains and can be sutured easily, secondary wound closure is the main problem. If the drains which are placed into the parotid or head and neck regions have little or no leakage after 48 h, they are Fig. 1A–F Diagram of fixation of the drain and closure of the wound with mattress suture after removal of the drain . A–C (upper removed, and the remaining skin defect heals secondarily. row), closure of the wound with mattress suture, insertion of the Srirompotong and Srirompotong suggest that retention drain and tying the knot; D–F (lower row), fixation of the drain and of a drain over the long term may cause emphysema in the closure of the wound after removal of the drain head and neck region . The areas in which the drain has been placed may be mobile, and because of the movement of the facial structures the drain scar may expand and easy closure of the skin defect after drain removal. Many widen. authors may have used this method in the past. However, To overcome this problem, nylon sutures were used to there have been no data in the literature regarding secure the Penrose drains. In this technique a horizontal stabilization of the Penrose drain or the knotting tech- mattress suture was tied around the Penrose drain and, nique as described above. after a loop, the suture perforated the drain and secured it We suggest that this attachment technique may be used onto the operative field. After removal of the drain, the to obtain an acceptable scar in regions such as perioral remaining suture closes the defect without need for any and/or parotid cheek areas in which we have placed local anesthesia (Fig. 1). With this technique, we can Penrose drains. We wish to bring this simple, beneficial, provide both attachment for the drain on mobile areas and effective, and old knotting technique to the surgeon’s attention. N. Sarifakioglu ( ) · G. Aslan · A. Terzioglu · F. Bingul Department of Plastic and Reconstructive Surgery, Ankara Training and Research Hospital, References Cebeci, Ankara, Turkey e-mail: email@example.com 1. Srirompotong S, Srirompotong S (2002) Surgical emphysema Tel.: +90-312-2126262, Fax: +90-312-2213276 following intraoral drainage of buccal space abscess. J Med Assoc Thai 85(12):1314–1316 N. Sarifakioglu Angera Evleri, F-6 Blok No: 40, 06800 Beysukent, Ankara, Turkey
European Journal of Plastic Surgery – Springer Journals
Published: Apr 1, 2004
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