Wash the abdomen before surgery, drain for people with abdominal trauma

This is an automatically translated article.

The article is professionally consulted by Master, Doctor Nguyen Thai Binh - Gastroenterologist - Department of General Surgery - Vinmec Ha Long International General Hospital. Master, Doctor Nguyen Thai Binh has more than 20 years of experience working in abdominal surgery.
Abdominal exploration is the first stage to help identify pathological lesions before surgery. make an appropriate surgical decision. For penetrating wounds, abdominal exploration is mandatory and cannot be ignored.

1. Why is abdominal exploration necessary?

For patients with abdominal trauma, abdominal exploration is a necessary and important step, deciding all interventions on the abdominal organs of patients with abdominal trauma.
The goal of abdominal exploration is to determine the exact location, nature of the lesion and its relationship with other parts of the abdomen to make an appropriate surgical decision.
Today, with the advancement of science and technology, gastrointestinal endoscopic and laparoscopy procedures can help doctors more fully determine the extent of injury and abdominal trauma in patients and provide the most appropriate treatment plan. In particular, for patients with penetrating abdominal wounds, abdominal exploration is a mandatory and extremely important step.
When conducting abdominal exploration, the doctor must ensure the principle of fully identifying the lesion and not omitting any position, especially for patients with abdominal trauma, the entire area must be thoroughly explored. Abdominal. In the case of only probing the pathology of each individual organ, it is only necessary to make small incisions corresponding to the location of the organ to be explored.

2. When to perform exploratory laparotomy, cleaning, and drainage?

If the patient has abdominal trauma or needs to carry out intra-abdominal surgery, the doctor will appoint exploratory laparotomy, cleaning and drainage.
However, this technique is contraindicated in patients who have not used other non-invasive diagnostic methods and have contraindications to anesthesia.

3. Procedure of laparotomy, exploratory laparotomy, cleaning and drainage

To ensure the safety of the patient's health and life, the process of performing laparotomy, exploration, abdominal washing and drainage for patients with abdominal trauma must be performed at a reputable hospital. , has a system of guaranteed facilities, a team of skilled and professional surgeons.
Patients before laparotomy, cleaning and drainage are prepared as usual surgery, enemas the day before and the morning of surgery. Prepare a complete medical record, pay attention to detect co-morbidities such as: Cardiology, diabetes, blood pressure, urology...
Procedures for exploratory laparotomy, cleaning and drainage includes:
3.1 Step 1: Wash the abdomen before surgery After the patient is anesthetized, the nurse will perform the abdominal lavage with gauze forceps with the sequence: 1 gauze wash, 1 gauze wash in a spiral from incision up to the sternum area, 1 wash swab from the incision to the upper pubic area and 1 side of the thigh, 1 wash swab from the incision to the upper pubic area and the other thigh, 1 wash swab from the pubic bone to the vulva . After washing the abdomen, continue to wash the vagina and catheterize. 3.2 Step 2: Conduct abdominal exploration Stage 1: Exploration of the liver and extrahepatic biliary tract
Laparotomy: Normally, the surgeon will make an incision in the midline above the umbilicus or the midline on the umbilicus in combination with the opening perpendicular to the abdomen. right side or go under the right flank. Exploration of the right lobe and extrahepatic biliary tract. Left lobe exploration: The step of explorating the left lobe of the liver is very easy to do, the doctor will put the valve to raise the incision so that the upper surface of the left lobe can be seen and gently press the lower border of the left lobe down to examine it. the entire upper surface of the left lobe of the liver. Continue to pull the stomach down and raise the incision, you will see the underside of the left lobe of the liver. Then 2: Exploration of the spleen
Because the spleen is located very deep, the exploration process is relatively difficult. The doctor will place a valve that pulls the left edge of the incision to the left and pulls the stomach down and to the right and then shines a light on the spleen area to see the splenic stalk and anterior part of the spleen.
Tense 3: Probing the stomach
Probing the anterior part of the stomach Probing the upper part of the stomach Probing the lower part of the stomach Probing the back side Probing the other organs
The organs will be examined in order from the small intestine to the colon, uterus and appendages and record any abnormalities, treat the lesions if any.
3.3 Step 3: Placement of Abdominal Drain The patient can be placed for a follow-up, therapeutic or prophylactic drainage depending on the purpose and requirements of the physician.

4. Principles when placing drainage for people with abdominal trauma

The most direct guarantee: Place the drainage into the fluid collection or the lowest position of the sinus to be drained in the patient. Shortest guarantee: The drain will be taken out of the patient's body in the shortest distance. Do not drain through the incision. Do not place drainage adjacent to important structures such as blood vessels, nerves, and joints. The drain must be fixed to the skin to prevent the drain from slipping out or into the patient's body. The drain must be withdrawn immediately after the drain has ceased to function. Patients after surgery to explore the abdomen and place a drainage tube, need to take care of the incision, wash and change the dressing regularly. When the patient is fully awake, the head should be elevated to avoid kinking the drain.
Laparoscopic surgery has more advantages thanks to small incision scars, less pain, short hospital stay, fast recovery, and early return to normal life.
Performing laparoscopic surgery and other types of surgery should generally be carried out in reputable hospitals to minimize the possibility of possible complications.
Vinmec International General Hospital gathers a team of qualified and skilled medical doctors from all over the country and abroad; The equipment system is invested heavily, meeting international standards, thus ensuring the best possible surgery.

Please dial HOTLINE for more information or register for an appointment HERE. Download MyVinmec app to make appointments faster and to manage your bookings easily.