A prospective randomized controlled trial of suction versus non-suction to the under-water seal drains following lung resection

Abstract

Applying suction to the underwater seal drains following lung surgery makes no difference in terms of air leak duration. In the light of this finding we have adopted a uniform policy of no suction being applied to the underwater seal, from the time of surgery, unless a specific clinical judgment is made to use it. The anticipated gains are that this will reduce work and cost and aid mobilization.

A new bioabsorbable sleeve for lung staple-line reinforcement (FOREseal™): report of a three-center phase II clinical trial

“…All dealt with bovine pericardium, and none demonstrated any cost effectiveness benefit. Furthermore, such comparisons should now integrate the adjunct of various strategies that have been proved to be effective in the prevention of persistent air leaks, i.e., creating a pleural tent [23], and early cessation of continuous suction and placing chest tubes to an underwater seal [24]. Furthermore, the management of persistent air leaks should also incorporate provocative chest tube clamping and permissive chest tube…”

Thopaz Portable Suction Systems in Thoracic Surgery: An end user assessment and feedback in a tertiary unit

“…Suction is applied to the chest drain systems in the presence of continuous air-leak or when the lung is not fully expanded [3,5,6]. There is a continuing debate on the role of suction in thoracic surgery [7,8].…”

Pleural procedures and thoracic ultrasound: British Thoracic Society pleural disease guideline 2010

“…In trauma and postoperative patients, suction has been shown not to improve pneumothorax resolution times or chest drain duration91 92 and, in some cases, may potentially be detrimental 93 94. It is difficult, however, to extrapolate this evidence to the medical use of chest drains.…”