title: Management of Chest Drains: A National Survey on Surgeons-in-training Experience and Practice.
abstract: BACKGROUND
  Chest tube insertion is a simple and sometimes life-saving procedure performed mainly by surgical residents. However with inadequate knowledge and poor expertise, complications may be life threatening.
  
  
  OBJECTIVE
  We aimed to determine the level of experience and expertise of resident surgeons in performing tube thoracostomy.
  
  
  METHODS
  Four tertiary institutions were selected by simple random sampling. A structured questionnaire was administered to 90 residents after obtaining consent.
  
  
  RESULTS
  The majority of respondents were between 31 and 35 years. About 10% of respondents have not observed or performed tube thoracostomy while 77.8% of respondents performed tube thoracostomy for the first time during residency training. The mean score was 6.2 ± 2.2 and 59.3% of respondents exhibited good experience and practice. Rotation through cardiothoracic surgery had an effect on the score (P = 0.034). About 80.2% always obtained consent while 50.6% always used the blunt technique of insertion. About 61.7% of respondents routinely inserted a chest drain in the Triangle of safety. Only 27.2% of respondents utilized different sizes of chest tubes for different pathologies. Most respondents removed chest drains when the output is <50 mL. Twenty-six respondents (32.1%) always monitored air leak before removal of tubes in cases of pneumothorax. Superficial surgical site infection, tube dislodgement, and tube blockage were the most common complications.
  
  
  CONCLUSIONS
  Many of the surgical resident lack adequate expertise in this lifesaving procedure and they lose the opportunity to learn it as interns. There is a need to stress the need to acquire this skill early, to further educate and evaluate them to avoid complications.
authors.affiliation: Department of Surgery, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria.
authors.forename: Emeka B
authors.initials: EB
authors.lastname: Kesieme
authors.affiliation: Department of Surgery, Lagos University Teaching Hospital, Lagos, Lagos State, Nigeria.
authors.forename: Olugbenga
authors.initials: O
authors.lastname: Olusoji
authors.affiliation: Department of Surgery, Aminu Kano University Teaching Hospital, Kano, Kano State, Nigeria.
authors.forename: Ismail Mohammed
authors.initials: IM
authors.lastname: Inuwa
authors.affiliation: Department of Surgery, University of Nigeria Teaching Hospital, Enugu, Enugu State, Nigeria.
authors.forename: Chukwuma Innocent
authors.initials: CI
authors.lastname: Ngene
authors.affiliation: Department of Surgery, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria.
authors.forename: Eghosa
authors.initials: E
authors.lastname: Aigbe
keywords: Chest drains; experience; practice; surgical residents