Internal jugular vein ligation

If sepsis is still uncontrolled, there is still swelling and tenderness in the internal jugular vein, suggesting that the infection is still expanding, or metastatic systemic abscess should be considered, and internal jugular vein ligation should be considered. Since the widespread use of antibiotics, internal jugular vein ligation has rarely been used. Curing disease: Indication Internal jugular vein ligation is suitable for sepsis that remains uncontrolled. There is still swelling and tenderness in the internal jugular vein, suggesting that the infection is still expanding, or metastatic systemic abscess occurs. Preoperative preparation Anesthesia and position The patient is supine, the head is turned to the opposite side, the shoulder is raised high, the head is backward and slightly drooping, so that the leading edge of the sternocleidomastoid muscle is clearly visible. 1% lidocaine plus 1 adrenaline in the incision skin, subcutaneous and local tissue infiltration of anesthesia, general anesthesia. Surgical procedure Surgical procedure A 5-6 cm long incision was made 2 cm below the mandibular angle along the anterior border of the sternocleidomastoid muscle. After separation of the superficial fascia and platysma, the sternocleidomastoid muscle was exposed, and the anterior border was separated downward, and the sternocleidomastoid muscle was pulled backward to expose the carotid sheath. After the carotid sheath was incised, a deep blue internal jugular vein was seen, located on the posterior side of the carotid artery. The vagus nerve was placed between the artery and the vein. The vein was carefully dissected with a curved vascular clamp, and a blunt curved aneurysm needle was used. The thick wire bypasses the healthy internal jugular vein, double-lumen ligation is performed above the facial vein, and the above branches are ligated, and the vascular stump can be fixed or embedded in the surrounding tissue. The incision was sutured in turn, and the rubber drainage strip was placed in the lower part of the incision. If there was no secretion, the drainage strip was withdrawn 24 to 48 hours.