Dead Space Management
Dead space in a wound is any area that remains devoid of tissue after closure of the wound. Dead space is created by either removing tissue in the depths of a wound or by not reapproxlmating all tissue planes during closure. Dead space in J wound usually fills with blood, which creates a hematoma with a high potential for infection.
Dead space can be eliminated in four ways. The first is by suturing tissue planes together to minimize the postoperative void. A second method is to place a pressure dressing over the repaired wound. The dressing ‘compresses tissue planes together until they are either bound
hy fibrin or pressed together by surgicaledema (or both). This usually takes about 12 to 18 hours. The third way to iminate dead space is to place packing into the void it bleeding has stopped and then remove the packing.
i technique is usually used when the surgeon is II hie to tack tissue together or to place pressure dressin (e.g., when bony cavities are present). The packing rna erial is usually impregnated ~’ith an antibacterial medication to lessen the chance of infection. The .fourth means of preventing dead space is through the use of drains, either by themselves or in addition to pressure
dressings. Suction drains continually remove any blood.
that accumulates in a wound until the bleeding stops and the tissues bind together and eliminate dead space. Nonsuction drains allow any bleeding to drain to the surface rather than to form a hematoma (Fig. 3-5).