What does closed drainage mean

Closed chest drainage is a common treatment method, which is used for drainage of hemothorax, pneumothorax, or empyema. It plays a very important role in the treatment of the disease. However, we must know that this technical operation requires high professionalism, and its precautions and principles must be followed after the operation and treatment. The following is an introduction to the specific closed drainage operation and precautions.

1. Overview

Closed chest drainage is to place one end of the drainage tube into the chest cavity and connect the other end to a water seal bottle at a lower position to discharge gas or collect fluid in the chest cavity, so that the lung tissue can reopen and restore function. As a treatment method, it is widely used in the drainage of hemothorax, pneumothorax, empyema and after thoracotomy, and plays a very important role in the treatment of the disease.

2. Operation method

1. The patient lies in a sloped position. The surgical site should be determined based on physical signs, chest X-ray or ultrasound examination and marked on the chest wall. Routine skin disinfection is performed, the operator wears sterile gloves, spreads sterile towels, and local anesthesia is performed.

2. First, puncture the pleural cavity with a syringe to determine the lowest drainage position. Make a skin incision, use straight forceps to separate the muscle layers (cut open if necessary), and finally separate the intercostal muscles to enter the pleural cavity (the parietal pleura should be injected with sufficient local anesthetic) and insert a larger rubber tube. The length of the drainage tube extending into the chest cavity generally does not exceed 4 to 5 cm. The drainage tube is fixed to the skin of the chest wall with sutures, and the end is connected to a sterile water seal bottle.

3. Notes

1. The intubation site or incision site must be accurate.

2. During local anesthesia, the pleura must be fully infiltrated, which can not only relieve pain but also avoid pleural shock.

3. Before intubation, puncture and aspiration must be performed with an injection needle to prove the existence of an air cavity or a liquid cavity.

4. The intubation depth should be marked in advance.

5. After intubation, the drainage tube is immediately connected to the water seal bottle and it is confirmed that the drainage tube is unobstructed. Otherwise, the position or depth of the drainage tube should be adjusted.

6. When draining fluid, the amount should not exceed 1000 ml at a time to avoid pulmonary edema after lung re-expansion.

7. The drainage tube must be fixed vertically to the skin to avoid skin compression necrosis.

8. The disinfectant water in the drainage bottle should be replaced once a day. When replacing the drainage bottle, you must use two vascular clamps to clamp the chest drainage tube before opening the drainage bottle cap.