Common Drain Supplies

COMMON DRAIN SUPPLIES


Access

A lot of access to kidneys, gallbladder, and other places may use a larger sized access kit than a micropuncture set. These go by a few different names and have a few different parts that come with them, but the standard parts in an access kit are:

  • 21 gauge Chiba needle. A chiba is a hollow needle with a sharp, pointed stylet that goes inside the hollow needle. 
  • A longer, likely stiffer, 018 access wire. It is usually 60 to 80 cm.
  • An introducer sheath- This can be 5 or 6 French, and like a micropuncture kit, can accommodate an 038 wire after the inner dilators are taken out.


Common names of these products are

  • Mac-N-V made by Merit Medical
  • AccuStick made by Boston Scientific
  • GrebSet made by Teleflex. It has a directional tip on the catheter.
  • 15 cm stiff micropuncture kits made by various manufactures
  • Others not listed


Wires Used

Access Wires

  • 018 Nitrex Wire made by Medtronic in 80 cm. By far the best wire made in this length. The tip will not kink and the wire has stiffness to get the sheath into the body. The wire is expensive, but usually worth it.


Drain Wires

  • Amplatz 80cm- A stainless steel stiff wire that has a flexible tip.
  • Stiff Glidewire- A stiff hydrophilic wire that is atraumatic and usually has an angle on it.


These are the main two wires for any drain placement or exchange. There may be others, but it has been mostly these two for me and my experience. A bentson wire may be used ( a softer, stainless steel wire with a flexible tip.)


Drains

There are two types of drains: APD and locking pigtail. These are for most locations that you will place a drain. These are usually around 25 cm long and start at 6 french. Most drains that are placed start at an 8F size and go up as needed.


APD (All Purpose Drain)

Usually has a curve on the tip. Usually used for Chest tubes and small pockets of infection that a pigtail may not fit in, but a larger drain is needed. 

Locking Pigtail

This drain uses a suture to keep the end of the drain in a loop. This will help the drain stay in place inside larger cavities of fluid or inside cavernous parts of organs, like the gallbladder or the collecting system of the kidney.


Biliary Drain

Just like the name says, this drain is for the biliary system. It is a longer drain with more holes in it. The holes also go up the shaft of the drain so that if there is a stricture in the common bile duct, the bile will drain. 



Drain Prep


If it is a new placement drain, the metal stiffener will likely be used to gain access. For a drain exchange, the plastic stylet will be used to straighten out the drain.

Lesson Summary

Common supplies used in these procedures include:

  • Access Kits:
    • 21 gauge Chiba needle with a sharp, pointed stylet inside
    • 018 access wire (usually 60 to 80 cm)
    • An introducer sheath (5 or 6 French) that can accommodate an 038 wire
  • Common names for access kits include Mac-N-V (made by Merit Medical), AccuStick (made by Boston Scientific), and GrebSet (made by Teleflex)
  • Wires:
    • Access Wires: 018 Nitrex Wire (made by Medtronic) - the best wire in this length, doesn't kink, with stiffness to get the sheath into the body
    • Drain Wires: Amplatz 80cm (stainless steel stiff wire with a flexible tip) and Stiff Glidewire (stiff hydrophilic wire with an angle)
  • Drains:
    • APD (All Purpose Drain) - usually has a curved tip, used for chest tubes and small pockets of infection where a larger drain is needed
    • Locking Pigtail - uses a suture to keep the end of the drain in a loop, helps drain larger cavities of fluid or cavernous parts of organs
    • Biliary Drain - longer drain with more holes, used for the biliary system

For drain prep:

  • If it's a new placement drain, the metal stiffener is likely used to gain access
  • For a drain exchange, the plastic stylet is used to straighten out the drain

Complete and Continue