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Eur J Cardiothorac Surg 2005;27:134-137
© 2005 Elsevier Science NL

The use of flexible spiral drains after non-cardiac thoracic surgery. A clinical study

Thoracic Surgery Unit, Verona City Hospital, Azienda Ospedaliero, Verona, Italy

Received 23 July 2004; received in revised form 7 October 2004; accepted 11 October 2004.

^* Corresponding author. Address: Unità Operativa di Chirurgia Toracica Ospedale Maggiore, Azienda Ospedaliero, P.le Stefani 1, 37126 Verona, Italy. Tel.: +39 045 8072312; fax: +39 045 8072046. (E-mail: alterzi{at}libero.it).

Objective: After an observational study on 50 patients determined the efficacy and safety of a small calibre (19F), flexible, fluted spiral drains with round cross-section after non-cardiac thoracic surgery we undertook a prospective study to compare these drains to standard chest drains also in terms of pain using a Visual Analog Score. Methods: One hundred consecutive patients who had to undergo non-cardiac chest surgery either by thoracotomy or by VATS were randomly assigned to receive small calibre drains with round cross-section (group A) or the standard chest drains (group B) to drain the pleural space. Drains were connected to a unitized chest drainage system. Pain was assessed using a Visual Analog Scale (VAS) 0–100. Results: The amount of fluid evacuated daily in patients who received the spiral drains was as much as 1150ml, that of patients who received standard drains was as much as 950ml. In no case did spiral drains have to be replaced with standard tubes. In group A first drain was removed after a mean of 3.4 days and the second after a mean of 5.9 days; in group B after a mean of 4.1 and 6.1 days, respectively. Patients were discharged after a mean of 8.5 days in group A (SD 4.04) and 8.1 days in group B (SD 4.76). There were no drains-related complications in both groups. The drains-related pain for the patient was significantly less for patients with spiral drains compared to standard drains at rest, during cough induced by respiratory therapists and at the time of removal. Conclusions: Spiral drains proved to be at least as safe and effective as conventional tubes after lung surgery; they allowed for evacuation of large amounts of blood/fluid as well as air, and were associated with minimal discomfort.

Key Words: Pleural space • Postoperative care

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