Chest Drain Fall-Out Rate According to Suturing Practices: A Retrospective Direct Comparison

Area of Science:

• Thoracic Surgery
• Medical Device Management
• Patient Safety

Background:

• Chest drains frequently dislodge, necessitating replacement and increasing patient risks.
• Current practices lack evidence-based standardization for preventing chest drain fall-out.
• Suturing is a potential measure to reduce drain displacement, but lacks direct supporting data.

Purpose of the Study:

• To investigate the association between chest drain suturing practices and the rate of drain fall-out.
• To provide evidence for standardized, safer chest drain management protocols.

Main Methods:

• Retrospective analysis of 369 chest drain insertions from 2015-2016.
• Data collected from electronic patient records, defining "fall out" as unintentional dislodgement outside the pleural cavity.
• Comparison of fall-out rates between sutured and unsutured chest drains.

Main Results:

• Sutured drains (n=106) had a fall-out rate of 6.6%, compared to 14.8% for unsutured drains (n=263; p=0.04).
• The mean time to fall-out was similar for both groups, but the incidence was significantly lower in sutured drains.
• This suggests a protective effect of suturing against unintentional chest drain removal.

Conclusions:

• Suturing chest drains appears to be associated with a reduced rate of fall-out.
• The findings support the implementation of drain suturing as a measure to improve patient safety.
• Further evidence-based guidelines are recommended for chest drain management.