[Small flexible drains after cardiac surgery. Efficacy and safety of a new system]

The use of thoracic drains after cardiac surgery is distressing to patients and can cause a local inflammatory response. The objective of this study was to demonstrate the efficacy and safety of the flexible Blake drain for mediastinal and pleural drainage following cardiac surgery.

We retrospectively studied 292 consecutive patients who underwent open heart surgery. The patients were divided in 2 groups: group A: 152 patients (Blake drain, 19 Ch) and group B: 140 patients (semi-flexible drains, 32 Ch). There were no significant differences in gender (56 males and 96 females in group A vs 49 males and 91 females in group B), age (67 +/- 14 in group A vs 65 +/- 14 in group B) or type of intervention (group A: 90 coronary, 59 valvular, 3 other; group B: 82 coronary, 53 valvular, 6 other). Preoperative parameters were similar in both groups. All patients received tranexamic acid as anti-fibrinolytic treatment.

Postoperative bleeding was lower in group A (742 +/- 368) than in group B (872 +/- 439) (p = 0.042). The number of transfusions and re-operations for bleeding re-exploration was similar in both groups. Patient satisfaction was significantly greater in the group with flexible drains (p < 0.005).

The use of flexible Blake drains reduced drainage after cardiac surgery without increasing the risk of bleeding or tamponade and can therefore be systematically used in cardiac surgery. Because of their flexibility, these drains produce less irritation, with accelerated recovery and lower analgesic use.