Usefulness of flexible silicone drainage versus conventional plastic drainage in thoracic surgery.

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The pleural drainage’s main objective is to restore the negative pressure in the pleural cavity and evacuate the liquid and air remaining after surgery, apart from allowing an early detection of possible complications. The first person to use them routinely in post thorax surgery patients was Lilienthal in 1922. Since then, several types of drainage have been created and today the most commonly used is the semi-rigid plastic drainage with active or passive aspiration, whose main inconvenient is that, since they are rigid, they cause pain after surgery, not allowing the patient to move in the early days and making it difficult for them to get back to their ventilatory dynamics. So it increases the length of the hospital stay. Because of this, soft silicone drainages were introduced, given that the patients adapt to them better but, despite this, they have not been widely spread due to a lack of studies that confirm their usefulness for both liquid and air drainage. Silicone drainages are softer and each of their sections has a different shape, longitudinally slotted in the proximal sections that work through capillary action, and round-shaped in distal sections, in order to avoid any possible obstruction. In early studies their main inconvenient was the complications that appeared when evacuating air where there is a persistent air leak. Passively aspirational conventional drainages were considered the most suitable option for patients with a small air leak and the actively aspirational ones for treating patients with a major air leak. This is why a randomized clinical trial was performed so we can determine the usefulness of soft silicone drainages in post-operative thorax surgery. .

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