How to secure the connection between thoracostomy tube and drainage system?

• Published in: World journal of emergency medicine Vol. 5; no. 4; pp. 259 - 263
• Main Authors: Li, Ka Ki Pat, Wong, Kit Shing John, Wong, Yau Hang Henry, Cheng, Ka Lok, So, Fung Ling, Lau, Chu Leung, Kam, Chak Wah
• Format: Journal Article
• Language: English
• Published: China World Journal of Emergency Medicine (WJEM) 01.01.2014; Second Affiliated Hospital of Zhejiang University School of Medicine
• Subjects: Adhesion; Adhesives; Methods; Original; Ostomy; Cross-taping; Thoracostomy tube; Drainage system
• ISSN: 1920-8642
• DOI: 10.5847/wjem.j.issn.1920-8642.2014.04.003

BACKGROUND: Thoracostomy tube insertion is one of the common bedside procedures in emergency medicine and many acute specialties. Dislodgement of thoracostomy tube from the connection tube of chest drainage system is an important problem with potential complications such as contamination, infection and pneumothorax. Besides, mere loosening can also lead to malfunction. It is a common practice to tape the connection of the system. This study aimed to evaluate the materials and methods of connection of chest drain system to minimize drainage dislodgement. METHODS: We conducted an experimental study to assess the tightness of the connection with various taping materials and methods. We selected three commonly used adhesive materials(3Mtm Transporetm Medical tape, 3Mtm Microporetm Medical tape, 3Mtm Soft Cloth Tape on Liner) and three different methods（cross method, straight method, nylon band） to secure the junction between the thoracostomy tube and the bi-conical adaptor in the drainage system. The measured outcome was the weight causing visible loosening of the junction between thoracotomy tube and the adaptor.RESULTS: For each taping material and taping method, 10 trials were performed. The median weight required to disconnect the junction is 26.22 lb for Transporetm, 31.29 lb for Microporetm and 32.44 lb for Soft Cloth Tape on Liner. A smaller force was required to disconnect if Transporetm is used（P<0.001）. There was no statistical signifi cant difference between Microporetm and Soft Cloth Tape on Liner（P=0.98）. The median disconnecting force is 32.44 lb for straight taping method, 40.55 lb for cross taping method and 21.15 lb for plastic band. The cross-taping method was the more secure method（P<0.0001 when compared with plastic band）（P=0.033 when compared with straight method）.CONCLUSION: Cross-taping is the most secure method among the tested varieties in connecting the thoracostomy tube to the chest drainage system. Transporetm is not a recommended material for thoracostomy tube taping.