Close suction drain system made with 20 cc syringe and nasogastric tube (Ryle’s tube) for head and neck surgery: a Technical Note

The first ever recorded historical evidence for surgical drains were found in the era of Hippocrates (circa 460-377 BC). The Greek Physician Hippocrates used hollow tubes for the treatment of empyema. Surgeries of the head and neck region are associated with clinically significant post-operative morbidities such as haematomas, seromas, surgical site infection and skin flap complications. “Closed surgical drains” are used widely to prevent such complications and is considered the standard of care for head and neck surgical wounds as they obliterate the dead space and prevent seroma and hematoma formation. The negative pressure created by a closed surgical drain improves the skin apposition and wound healing, particularly when extensive undermining had been done during dissection. “Radivac drains” (negative suction drains) are considered the standard of practice in head and neck surgery. However, the limited affordability of the healthcare systems in developing countries, drive clinicians to find cheaper alternatives to Radivac drains. This article elaborates the use of closed suction drain system assembled with 20cc syringe and Ryle’s tube which has been effectively used in the University Dental Hospital Peradeniya for decades.