Less pain with flexible fluted silicone chest drains than with conventional rigid chest tubes after cardiac surgery

Abstract

Drainage of the pleura and mediastinum after cardiac surgery is routinely achieved with rigid, wide-bore plastic drains. 1 Although these drains are effective, they are also painful, particularly during removal, 2 and they may cause damage to bypass grafts, impair ventilation, and cause cardiac arrhythmias. 3 Flexible fluted silicone drains may be just as effective. 4 Because of the fluted design, smaller sizes can be used without any reduction in the effective drainage capacity. The small size and flexibility may cause less pain, interfere less with the heart and surrounding structures, and result in fewer drain site infections. To investigate these potential benefits and to establish the efficacy of these drains, we designed a prospective, randomized trial that compared the two types of drain.

Management of spontaneous pneumothorax: British Thoracic Society pleural disease guideline 2010

“…Their success has been documented in several studies,83–89 the attachment of Heimlich valves facilitating mobilisation and outpatient care. Small-bore chest drains have been shown to have a similar success rate to larger drains90 while being less painful,91 92 but there have been no randomised controlled trials comparing them with NA. More detail on chest drain insertion and management and complications of chest drain insertion are found in the guideline on pleural procedures.…”

Small-bore pigtail catheters for the treatment of primary spontaneous pneumothorax in young adolescents

“…Simple aspiration is technically straightforward, but is limited by a high rate of failure (up to almost 50%) 6–8. Insertion of large-bore chest catheters can be effective, but is limited by a higher risk of complications and increased post-procedural pain 9. In an effort to reduce the complications and pain associated with the placement of large-bore chest catheters, small-bore pigtail catheters have been used and found to be effective in the treatment of adult PSP 3 10–12.…”

Management of Spontaneous Pneumothorax and Post-Interventional Pneumothorax: German S3 Guideline

“…offer the same success rate as larger-lumen chest drains (> 14 Ch.) [112,116], are less painful [118] and associated with a lower complication rate [115,116]. Both the drainage time [115,119] and the in-hospital treatment time were shorter for patients with small-lumen drains [115,116] The recurrence rate of pneumothorax can be reduced by means of pleurodesis via the chest drain.…”