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.