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A method for mediastinal drainage after cardiac procedures using small silastic drains
J A Obney1, M J Barnes, P G Lisagor
1Department of Cardiothroacic Surgery, Brooke Army Medical Center, Fort Sam Houston, San Antonio, Texas 78234, USA. seamusmd@aol.com
The Annals of Thoracic Surgery
|October 4, 2000
Summary
Flexible Blake drains offer a less painful and more effective alternative to traditional large-bore chest tubes for mediastinal drainage after cardiac surgery. This innovation allows for earlier patient discharge with comparable safety and efficacy.
Area of Science:
- Cardiovascular Surgery
- Thoracic Drainage Techniques
Background:
- Traditional teaching favors rigid, large-bore chest tubes for mediastinal drainage post-cardiac surgery.
- Less invasive surgical approaches are increasingly adopted in cardiac surgery.
- Smaller flexible drains have proven effective for various abdominal collections and chest drainage by interventional radiologists.
Purpose of the Study:
- To evaluate the efficacy and safety of using flexible, fluted Blake drains for mediastinal drainage in cardiac surgery.
- To compare Blake drains with standard large-bore chest tubes in terms of outcomes and patient experience.
Main Methods:
- Implementation of 10-mm flexible, flat, fluted Blake drains for mediastinal drainage.
- Application in over 100 cardiac surgical procedures, including coronary artery bypass grafting, valve operations, heart transplants, and tumor resections.
Main Results:
- Blake drains demonstrated comparable efficacy to large-bore chest tubes, with no increased risk of bleeding or cardiac tamponade.
- Patients experienced less pain, improved mobility, and facilitated earlier discharge with functioning drains.
Conclusions:
- Flexible fluted drains provide adequate mediastinal drainage, challenging the necessity of larger rigid tubes.
- The larger surface area of Blake drains may enhance drainage efficiency compared to traditional chest tube sideholes.
- This flexible drainage system presents a viable alternative to standard chest tubes in cardiac surgery.