Consensus Guideline
Pleural Drains in Adults
Role of assistant
- Encourage the patient to take deep breaths and release muscle tension during exhalation. Continuously reassure the patient during the procedure.
- Get the patient to practice the required breathing prior to removal of the drain.
- Identify purse string sutures - if present prepare purse suture for tying and ensure there is enough length of suture material to tie with ease.
- Pull sutures until insertion wound is sealed - do not pucker the skin.
- Tie purse string three times (if present) - double loop tie first knot of purse suture and then tie second and third knot.
- Post removal of a chest drain the drain site needs to be closed. This is achieved by either tightening the mattress suture and/or applying steri strips.
- If a mattress suture is used to close the drain site, check for gaping and apply steri-strip/s if required. Then apply adaptic or gelonet, a sterile gauze and occlusive dressing. The dressing is changed every 48 hours until the suture is removed (generally 7 days).
- If steri-strips are used to close the drain site, apply an occlusive dressing. Change dressing every 48 hours and remove when the drain site has healed.
- Instruct the patient to breathe normally once the drain is removed.