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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.