CLINICAL EFFECT OF ADDING NEGATIVE PLEURAL SUCTION TO UNDERWATER SEAL CHEST DRAINS IN TRAUMATIC CHEST PATIENTS
Main Article Content
Keywords
Thoracostomy, Chest tube, Traumatic pneumothorax, Hemopneumothorax, Hemothorax
Abstract
Background: The target of this research work is to evaluate the effect of intercostal tubes with negative pleural suction against underwater seal in patients with various forms of chest trauma who received chest tube to manage the chest trauma complications including clotted hemothorax and persistent air leak.
Methods: Two groups were randomly assigned to patients who had tube thoracostomy due to traumatic pneumothorax, hemothorax, or hemopneumothorax: A negative suction was attached to the chest tube in group A, while no suction was attached in group B.
Results: Sixty patients were listed in the study, 30 in the group without negative suction and 30 in the other group with negative suction. The variances, which enrolled in this study between both groups, were in hospital stay (p=0.391), air leak time (p=0.49) and other complications (p=0.61). However, group A patients with negative suction had a higher chance to have more air leak time than group B patients.
Conclusion: Negative pleural suction decreased the incidence of surgical emphysema, but it did not show any advantages over the chest drainage system without suction in patients with simple traumatic pneumothorax, hemothorax, or hemopneumothorax.
References
2. So SY, Yu DY. Catheter drainage of spontaneous pneumothorax: Suction or no suction, early or late removal? Thorax. 1982; 37(1):46-48.
3. Antanavicius G, Lamb J, Papasavas P, Caushaj P. Initial chest tube management after pulmonary resection. Am Surg. 2005; 71(5):416-419.
4. Ayed AK. Suction versus water seal after thoracoscopy for primary spontaneous pneumothorax: prospective randomized study. Ann Thorac Surg. 2003; 75(5):1593-1596.
5. Marshall MB, Deeb ME, Bleier JI, Kucharczuk JC, et al. Suction vs. water seal after pulmonary resection: A randomized prospective study. Chest. 2002;121(3):831-835.
6. Coughlin SM, Emmerton-Coughlin HM, Malthaner R. Management of chest tubes after pulmonary resection: A systematic review and meta-analysis. Can J Surg. 2012; 55(4):264.
7. Davis JW, Mackersie RC, Hoyt DB, Garcia J. Randomized study of algorithms for discontinuing tube thoracostomy drainage. J Am Coll Surg. 1994;179(5):553-537.
8. Morales Uribe CH, Villegas Lanau MI, Petro Sanchez RD. Best timing for thoracoscopic evacuation of retained post-traumatic hemothorax. Surg Endosc. 2008;22:91-95.
9. Cerfolio RJ, Bass C, Katholi CR. Prospective randomized trial compares suction versus water seal for air leaks. Ann Thorac Surg. 2001;71(5):1613-1617.
10. Brunelli A, Monteverde M, Borri A, et al. (2004) Comparison of water seal and suction after pulmonary lobectomy: A prospective, randomized trial. Ann Thorac Surg. 2004;77(6):1932-1937.
11. Brunelli A, Cassivi SD, Halgren L. Risk factors for prolonged air leak after pulmonary resection. Thorac Surg Clin. 2010; 20(3):359-364.
12. Alphonso N, Tan C, Utley M, et al. A prospective randomized controlled trial of suction versus non-suction to the under-water seal drains following lung resection. Eur J Cardiothorac Surg. 2005; 27(3):391-394.
13. Feenstra TM, Dickhoff C, Deunk J. Systematic review and meta-analysis of tube thoracostomy following traumatic chest injury; suction versus water seal. Eur J Trauma Emerg Surg. 2018; 44(6):819-827.