Capital & Coast DHB Cardiothoracic Service
Chest drains (also known as intercostal drains or chest tubes) are used frequently in the cardiothoracic service. The drains are flexible plastic tubes that can be placed through the chest wall to allow the removal of fluid or air. Chest drains may be inserted under local anaesthetic for things like a pneumothorax ("collapsed lung" due to air in the pleural cavity), or pleural effusion (fluid in the pleural cavity). The drains are connected to a collection chamber which allows fluid or air to get out of the chest, but not to get in. They may need to stay in place for a few days depending on the reason for their use.
Additionally a lot of cardiothoracic surgeries require chest drainage afterwards, the drains are inserted under general anaesthetic as part of the operation. All heart surgeries require two or more drains which are normally removed after a couple of days. These may be placed near the pericardium (outer sack) of the heart, inside the mediastium (central chest cavity) or the pleural cavity (around the lungs). Lung surgeries almost always require one or two chest drains as well, usually in the pleural cavity, which are removed when the fluid or air is no longer collecting.
Sometimes the collection chamber of the drain is required to be attached to a suction unit on the wall near your bed. This is sometimes used when there is a pneumothorax or an "air leak" (small break in the lung allowing air to move from the lung to the pleural cavity) post surgery. The suction removes the air from the pleural cavity and assists the lung to expand until the air leak has healed. You will be informed by your surgeon or nurse if suction is required. Having a chest drain on suction may limit your ability to move far from the bedspace, again your surgeon or nurse will talk to you about this.
Removal of a chest drain is a relatively quick and simple procedure involving two nurses. The insertion site is closed by a suture (stitch) which will need removing around 5-10 days later. Patients are usually back at home at this point so may have to arrange to see a practise nurse or GP for this.