Silastic drains vs conventional chest tubes after coronary artery bypass.
OBJECTIVE
To investigate differences in drainage amounts and early clinical outcomes associated with the use of Silastic drains, as compared with the conventional chest tube after coronary artery bypass grafting (CABG).


METHODS
Retrospective nonrandomized case control study.


METHODS
A tertiary teaching hospital.


METHODS
Outcome data from 554 patients who underwent postoperative pericardial decompression using small Silastic drains were compared with those from 556 patients who had conventional chest tubes after first-time CABG at our institution between January 1 and August 1, 2000.


RESULTS
Univariate analysis of preoperative characteristics was used to ensure similarity between the two patient groups. Operative mortality, mediastinitis, reoperation for bleeding, and early and late cardiac tamponade occurred in 9 patients (1.6%), 6 patients (1.1%), 6 patients (1.1%), 6 patients (1.1%), and 1 patient (0.2%), respectively, in the Silastic drain group, compared with 11 patients (2.0%), 9 patients (1.6%), 4 patients (0.7%), 2 patients (0.4%), and 6 patients (1.1%) in the conventional group. No statistically significant differences between the two drains were identified. Drainage amounts (mean +/- SD) were 552.2 +/- 281.8 mL and 548.8 mL +/- 328.7 mL for the Silastic and conventional groups, respectively (p = 0.51). Postoperative length of stay was longer for the conventional chest tube group (median, 5 d; range, 1 to 119 d) when compared to the Silastic drain group (median, 4 d; range, 1 to 66 d; p = 0.01).


CONCLUSIONS
We demonstrated that small Silastic drains are equally as effective as the conventional, large-bore chest tubes after CABG with no significant risk of bleeding or pericardial tamponade. Additionally, use of Silastic drains allows more mobility than the conventional chest tubes. As a result of this study, there was a change in our clinical practice toward the exclusive use of Silastic drains after all cardiac surgical procedures.
Frankel
Timothy L
TL
Section of Cardiac Surgery, Washington Hospital Center, Washington, DC, USA.
Hill
Peter C
PC
Stamou
Sotiris C
SC
Lowery
Robert C
RC
Pfister
Albert J
AJ
Jain
Arvind
A
Corso
Paul J
PJ
D000368:Aged; D016022:Case-Control Studies; D015505:Chest Tubes; D001026:Coronary Artery Bypass; D004129:Dimethylpolysiloxanes; D004322:Drainage / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011182:Postoperative Care / Q000295:instrumentation; D011184:Postoperative Period; D012189:Retrospective Studies; D012828:Silicones
D004129:Dimethylpolysiloxanes; D012828:Silicones; C013830:baysilon