Not Every Bulb Is a Rose: A Functional Comparison of Bulb Suction Devices¹

Background: Not all closed drainage suction bulbs are equivalent, and there may be a discrepancy between purported and observed clinical efficacy. We evaluated four popular bulb suction apparati to directly compare their maximum attainable suction, maximum volume collected, and negative pressure maintained relative to volume collected. Methods: Employing a developed-calibrated digital collection system, the relative function of the Surgidyne 100cc (SD100), Jackson-Pratt 100cc (JP100), Jackson-Pratt 400cc (JP400), and HemoVac 400cc (HV400) drains were compared. For these analyses, three separate drains of each type (JP100 utilized 6 drains) were tested in triplicate (α = 0.05). Results: The SD100 bulbs achieved the greatest negative pressure (-167.4 mmHg) while the HV400s the least (-80.5mm Hg). Only the SD100s pulled at or above purported volume. All other types obtained volumes significantly less than their described volumes: for each bulb type, the obtained volumes were statistically different. Of note, 66.7% (4 of 6) of JP100 bulbs collected only half the purported volume. Conclusions: The use of the SD100 bulb demonstrated superior maximum attainable suction, maintained suction to a higher volume; they were the only bulbs tested that collected volumes at or above those purported. The HV400 bulbs demonstrated the lowest suction and volume collected. Nevertheless, when used clinically, all such drain bulbs must be emptied long before achieving maximum volume to maintain reliable suction.