Use of a single silastic chest drain following thoracotomy: initial evaluation.
BACKGROUND
It is standard practice to use multiple large bore semi-rigid chest tubes to drain the pleural cavity following thoracic procedures. These can cause pain and discomfort at the insertion site.


METHODS
We describe our experience with the use of a single small silastic drain following thoracotomy. From November 2001 to November 2003, size 19-F silastic chest tubes (Blake drains) were used for drainage of the pleural cavity in 37 patients at our institution. The patients ranged in age from 18 to 81 years (mean 65). The operations included 22 lobectomies, two bilobectomies, 10 wedge resections, and three other procedures.


RESULTS
Total drainage in each patient ranged from 420 to 5440 mL (mean 1387 mL). Tubes were left in place for an average of 4.3 days (range 1-12). The average postoperative length of stay was 7.6 days (range 3-44, median 5). Three patients required insertion of an additional tube for dislodgement, persistent air leak, and bronchopleural fistula, respectively. These complications occurred among the first 15 patients in the present series. None of the patients had persistent pleural effusion. Subjectively, these tubes were more comfortable for the patients and were easier to remove.


CONCLUSIONS
The use of a single, small silastic chest drains following thoracotomy may be safe and effective in draining both fluid and air, though an additional tube may be necessary for persistent leaks.
Kejriwal
Nand K
NK
Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia. nkkejriwal@hotmail.com
Newman
Mark A J
MA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015505:Chest Tubes; D004129:Dimethylpolysiloxanes; D004322:Drainage / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D012828:Silicones; D013908:Thoracotomy
D004129:Dimethylpolysiloxanes; D012828:Silicones; C013830:baysilon