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Thinking outside the lung: improving the safety of pleural procedures
P29 Securing an intercostal chest drain without sutures
  1. S Kesavan,
  2. G D Angelini
  1. Bristol Heart Institute/University of Bristol, Bristol, UK

Abstract

Introduction and Objectives Securing an intercostal chest drain with sutures after insertion is an important step. Purse string sutures should not be used as it converts a linear incision to a circular, unsightly scar, during the healing process. Two mattress sutures are used—the first suture is to assist the latter closure of the wound after drain removal and the second a stay suture, to secure the drain. In an emergency situation and in the paediatric population, the technique is cumbersome. A novel chest drain is described where the chest drain is secured without sutures.

Method The novel idea involves securing a chest drain without sutures, with the help of two inflatable balloons (cuffs). An inner (I) and an outer (O) inflatable cuff, with a one way valve to inject air, prevents the chest drain from dislodgement. The risk of infection will be lower as the two inflatable cuffs and the intercostal muscles around the chest drain will provide a perfect fit. The chest drain is removed after deflating the balloons (cuffs) at the end of inspiration. Small gauge chest drains do not require a suture and the linear incision can be closed by suture strips, after removal of the chest drain. The novel chest drain is especially useful in patients with pneumothorax and in the paediatric population, providing a snug, secure and a stable position of the chest drain.

Conclusion The above chest drain provides a suture less method to secure an intercostal chest drain. It is especially useful in an emergency situation (tension pneumothorax) and in the paediatric population.

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