Tube Thoracostomy: Complications and Its Management

Tube thoracostomy is the most commonly performed surgical procedure in thoracic surgery. Tube thoracostomy can be life-saving and may require the intervention of general surgeons, intensivists, or emergency physicians.

Hewett, in 1867, was the first to describe a closed-tube drainage system for the drainage of empyema.  However, civilian and military hospitals gained valuable experience during World War II. Tube thoracostomy became the standard of care in the management of chest trauma. If you also require placement of a thoracic tube, then you must schedule an appointment via centese.com/thoracic-surgery/.

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Tube thoracostomy can be a complicated procedure. Inadequate knowledge or lack of experience may lead to complications. These complications can be classified as either technical or infective. Trocar technique is by far associated with a higher rate of complication.

Tube thoracostomy complications can be either technical or infectious. Technical causes include tube malposition, blocked drain, chest drain dislodgement, reexpansion pulmonary edema, subcutaneous emphysema, nerve injuries, cardiac and vascular injuries, and herniation through the site, chylothorax, and cardiac dysrhythmias.

Infective complications include empyema and surgical site infection including cellulitis and necrotizing fasciitis. Complication rates of tube thoracostomy have been found to be higher in critically ill patients with about 21% of tubes placed intrafissurally and 9% intraparenchymally.