From the Guidelines
The UK guidance recommends using ultrasound (US) for draining superficial post-surgical collections and computed tomography (CT) for deep collections, with the decision made on a case-by-case basis by a multidisciplinary team. When deciding on the drainage method, the team should consider the collection's size, location, and complexity, as well as the patient's symptoms and clinical status 1. Key factors influencing the choice between US and CT guidance include:
- Collection depth and location: US is preferred for superficial collections, while CT is indicated for deep intra-abdominal or pelvic collections 1
- Collection complexity: CT guidance is recommended for multiloculated collections or those near vital structures requiring precise needle placement
- Patient factors: US is particularly indicated for pediatric interventions due to the avoidance of ionizing radiation 1 The procedure should be performed using aseptic technique, with appropriate-sized catheters and samples sent for microbiological analysis. Post-procedure care involves leaving catheters in place until drainage is minimal and clinical improvement is observed. The goal of drainage is to relieve symptoms, prevent sepsis, and avoid complications from mass effect, while balancing the benefits of real-time visualization with the need for detailed anatomical information in complex cases 1.
From the Research
UK Guidance for Draining Post-Surgical Collections
There is no direct evidence from the provided studies that specifically outlines the UK guidance for when to use ultrasound (US) or computed tomography (CT) to drain a post-surgical collection. However, the studies provide information on the use of US and CT in draining post-surgical collections:
- The use of endoscopic ultrasound-guided drainage (EUS-GD) is discussed in 2 and 3, which suggest that EUS-GD is a safe and effective method for draining post-surgical fluid collections, with advantages over surgical and percutaneous drainage.
- The use of CT-guided aspiration is discussed in 4, which suggests that it is a safe and effective method for managing symptomatic postoperative seromas.
- The use of ultrasound to detect surgical site fluid collections is discussed in 5 and 6, which suggest that ultrasound can be a useful tool for detecting fluid collections and predicting surgical site infections.
Key Points
- EUS-GD is a safe and effective method for draining post-surgical fluid collections 2, 3.
- CT-guided aspiration is a safe and effective method for managing symptomatic postoperative seromas 4.
- Ultrasound can be a useful tool for detecting fluid collections and predicting surgical site infections 5, 6.
- The pattern of fluid collection can determine post-operative wound infection and morbidity 6.