(About Suction Devices)
Instrument usage: Suction instruments are considered accessory and ancillary instruments that are used to enhance the use of basic instruments or to facilitate a procedure.1 Suction or aspiration is when negative pressure is applied to evacuate blood, body fluid, tissue, or irrigating solution from the surgical site.2 Suctioning during a surgical procedure helps to provide better visibility. Suction can also be used to remove plume generated from electrosurgery or laser devices from the surgical field and should be attached to a smoke evacuator. Suction can be mechanical or manual with disposable or reusable tips.2 Suction tips come in an array of sizes and shapes that can be used in many surgical specialties.
Key differences:
The style of the suction tip is determined by where it will be used and the preference of the surgeon.2
For large amounts of blood or fluid, such as in abdominal surgery and trauma surgery, a Poole suction tip or Yankauer suction tip should be used so that the blood or fluid can be evacuated quickly.2
For less blood and more delicate surgery, such as in otolaryngology procedures, neurosurgery, and plastic surgery, a Fraiser suction tip may be used.2
Suction can be used to evacuate a cavity, such as a suction curette, and be attached to a suction machine that controls the amount of vaccum.2
Suction and irrigation during laparoscopic procedures is commonly doneusing a reusable or disposable suction irrigator.
Suction can also be attached to the port of a trocar, scope, or instrument.2
Small lumen suctions may have a stylet that can be used to maintain patency.
Safety on the sterile field:
The appropriate suction tip should be attached to the suction tubing that is passed off of the sterile field and connected to the suction generator for mechanical suction.
The suction tip should be attached to an empty syringe for manual suction.
Because the inner lumen of the suction tip is difficult to clean and sterilize, disposable suction tips are commonly preferred when their use is possible.2
Reusable suction tips should be irrigated with sterile water before to assure patency prior to use. If it is not patent, another suction tip should be used.
During the procedure, the scrub personnel should monitor the suction tip and clear it with sterile water when necessary. When using sterile water to clear suction, the scrub personnel must account for how much water is suctioned so that it is not part of the blood/fluid loss of the patient.
Some reusable suction tips have screws that must be accounted for during the surgical procedure and should be part of the initial and end instrument count.2
When suctioning delicate tissue, a lap pad, radiopaque sponge, or neurosurgical pattie may be used as a filter between the suction tip and tissue.1
At the end of the procedure, it is important to flush all reusable suction tips with sterile water to prevent organic debris from drying.2 This will assist in the central sterile processing of this instrument.
Instrument names:
Suction tips are commonly called by their name, such as “Yankauer” or “Frazier,” or may just simply be called “suction.” If different sizes of suction are needed, the scrub personnel should indicate the size of the suction when passing it to the surgeon or assistant.
References:
1. Rothrock, Jane C. Alexander's Care of the Patient in Surgery-E-Book. Elsevier Health Sciences, 2018.
2. Phillips, Nancymarie. Berry & Kohn's Operating Room Technique. Elsevier Health Sciences, 2016.