The Thoracic Drainage Tube is a thin, flexible, a plastic tube that the doctor inserts into the pleural space, the area between the chest wall and the lungs. The use of a pipe it is appropriate for many purposes, such as reexpanding a collapsed lung, treating pneumothorax or hemothorax by draining fluid or blood respectively, or the delivery of medications. This article explains how chest tubes work, what to expect during the insertion process, and possible complications.

Uses

THE place Chest tube is chosen for various situations, such as:

• Pneumothorax: The collapse of a lung due to the presence of air in the pleural space. Sometimes a lung can collapse without warning, which is known as a spontaneous pneumothorax. A pneumothorax can also occur as a result of an injury to the chest, such as a gunshot or stab wound.
• Empyema: The empyema -purulent collection- It is an infection that develops in the pleural space.
• Hemothorax: Hemothorax occurs when excessive blood accumulates in the chest cavity, usually due to injury, tumor or hemostasis disorder (bleeding disorder). It is likely to be placed Chest tube to prevent hemothorax after chest surgery.
• Pleural effusion: Pfluid accumulation in the pleural space, which may be due to heart failure, lymph fluid, lung malignancy, or infections such as tuberculosis and pneumonia.
• Pleural effusion. Pleurodesis requires the placement of a chest tube to administer chemicals into the pleural space.. These chemicals irritate the interior of the lung and cause a deliberate aseptic reaction (pleurodesis) which prevent the accumulation of fluid in this area. The doctor often connects the chest tube to a container that holds the fluid that drains.. It is possible to connect the container to a suction device to remove fluid or blood more effectively.

Types

Chest drain tubes come in different sizes. The doctor may use straight tubes or curved tubes.. The size of the chest tube will be chosen to suit the person's anatomy and the procedure. Chest tubes look like very large, plastic straws.

 Chest tubes generally come in two sizes: large and small diameter. Smaller tubes are also available and are known as intrapleural catheters (IPCs). Doctors carefully place them under the skin of the chest for long-term use. An intrapleural catheter (IPC) may be necessary for a person who faces continuous accumulation of pleural fluid due to chronic infection, malignancy or liver disease.

Procedure

The procedure can be performed with the patient under general anesthesia for chest tube insertion. Alternatively, local anesthesia is used, in which an anesthetic is used to numb the area before the tube is inserted, and the patient will also receive painkillers.. There are different incision approaches for chest tube insertion, but the procedure will follow the same basic steps: → Elevating the head of a person's bed by 30-60 degrees. The upper extremity is usually also elevated. of the affected side above the head.

→ Determine the tube insertion location. This will typically be between the fourth and fifth sides or between the fifth and sixth sides, in the mid-axillary line, just behind the pectoral muscle.

→ Decontamination of the skin with a solution. Doctors will let the skin dry before placing thesterile field on the patient.

→ Using a local anesthetic to numb the insertion site. Once the area is completely numb, the doctor can insert a needle deeper to see if they can draw fluid or air. This will confirm that they are in the right area.

→ By making an incision approximately 2-3 centimeters (cm) through the skin, the doctor will widen the incision and gain access to the pleural space. The insertion of the clamp must be slow to avoid puncturing the lung.

→ Inserting a gloved finger into the incision site. This is done to confirm that the area is the pleural space. The doctor also examines any unexpected findings, such as a mass or scar tissue.

→ Insertion of the chest tube through the incision site. If fluid begins to is drained through the tube, it is in the right place. It is also possible to connect the tube to a special chamber containing water that moves when a person breathes. If this movement is not observed, the tube may need to be repositioned..

→ The tube is sewn into place like this so that it is waterproofί

→ The tube insertion site is covered with gauze pads.

→ Chest X-ray can also help confirm the diagnosis. position of the pipe.

Complications

During a chest tube insertion, the doctor must work around several major organs, including the lungs and heart. It is a relatively safe procedure, but it does carry risks for certain complications. Possible complications include:

• Bleeding
• Infection 
• injury to the heart, blood vessels, or lungs
• perforation (puncture) of the diaphragm
• lung perforation

  The doctor should carefully explain these risks to the patient before the procedure. Ideally, chest tube placement is avoided in people who are receiving anticoagulant treatment (blood thinners). due to the risk of bleeding. However, chest tube insertion can sometimes be a life-saving and necessary emergency procedure.

Chest tube removal

The doctor removes the chest tube when it is no longer needed, that is, when the drainage of fluid stops.They will also remove the tube if it becomes blocked or not working properly. On average, the patient needs to keep the chest tube in for a few days. When removing a chest tube, the doctor removes The stitches that hold the tube in place will be removed and gently pulled out. The procedure may be uncomfortable, but it is not painful.

Recovery

Ideally, a person's symptoms will improve after place chest tube. The patient should monitor the incision site for points infection while it is healing and to inform their doctor as soon as possible if the wound swells, becomes red or start to produces pus. It is possible that a small scar will remain at the insertion site. A chest tube can be a relatively non-invasive way to access the pleural space to drain fluid or administer medications. Sometimes, if the chest tube doesn't resolve the problem, the patient , it may be necessary surgery surgery. After the chest tube is removed, the patient should follow the doctor's recommendations on how to care for the incision site.