Evidence to Support the Use of Occlusive Dry Sterile Dressings for Chest Tubes

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Abstract

Background

Conflicting medical literature suggests petroleum gauze dressings are necessary after chest tube (CT) placement. An urban academic medical institution in the northeast United States had been using dry sterile occlusive dressings at the CT site. However, to date no studies have examined use of this dressing material and rate of air leaks and wound infection.

Purpose

The purpose of this secondary data analysis was to identify evidence supporting use of a dry occlusive dressing as opposed to petroleum gauze dressing for preventing air leaks and wound infection at the CT site postoperatively.

Methods

The STS database was used to examine use within this institution of occlusive dry sterile dressings at the CT site, and outcomes of air leaks and wound infections. The first sample included all thoracic cases requiring CT placement. A subset was examined that included a homogenous sample of open thoracotomy and video-assisted thoracic surgeries requiring CT placement over a 2-year period.

Findings

Of the sample of 4,361, 134 air leaks (3.1%) and 21 wound infections (0.5%) developed. In the subset sample of 373 patients undergoing an open or video-assisted thoracotomy for lung cancer, the air leak rate was 8% and infection rate 0.5%. The medical record review suggests no air leaks or wound infections were attributable to the CT dressing or CT site itself.

Conclusion

Although more research is needed to support these findings, this review suggests a dry sterile dressing was as effective as an occlusive dressing for CTs in this setting.

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