Hi Matt, this is a good question. I think often times there is a fear that clamping will trap the pigtail suture on the inside of the tubing, however we have found this doesn't really seem to be the case because the suture can usually slide without issue (as shown in the video). Some people partially clamp before cutting the tube, then fully clamp after making their cut to further ensure they don't trap the locking suture. While this doesn't have too much of a downside, I think it generally is unnecessary.
@@Stepwards This particular pig tail drain allows you to release the suture by unlocking the mechanism. www.ciamedical.com/cook-medical-g09705-each-ult8-5-38-25-p-5s-cldm-hc-dawson-mueller
@@mariekristellemata4089 thank you for the added information! Yes the drainage catheter can be unlocked by releasing the mechanism however often times we find that once these catheters have been in place for some time (especially when they are draining fluids etc) that the suture gets stuck in the hub if you simply unlock it in the traditional manner. This is why many of us actually cut the tubing to make sure the suture is released. It is important to realize that whether you cut the tubing or unlock the mechanism both will allow for air to enter retrograde into the catheter which is why the tubing is clamped.
Isn’t there a small lever/lock that can be opened to release the suture? This way you don’t need to cut to release the suture or deal with the clamp. Also, do you have to have the patient hold their breath or engage in a valsalva maneuver when removing pigtail chest tubes or is that only reserved for the larger chest tubes? Thanks.
Yes but as the video explains if you were to open this lever air would be introduced into the pleural space as the seal is broken. Many providers do have the patent hold their breath or hum while the tube is being removed however it seems the most important maneuver is to have the xeroform ready to cover the hole immediately so you can apply an occlusive dressing.
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Clamping the tube probably still holds the pigtail string...no?
Hi Matt, this is a good question. I think often times there is a fear that clamping will trap the pigtail suture on the inside of the tubing, however we have found this doesn't really seem to be the case because the suture can usually slide without issue (as shown in the video). Some people partially clamp before cutting the tube, then fully clamp after making their cut to further ensure they don't trap the locking suture. While this doesn't have too much of a downside, I think it generally is unnecessary.
@@Stepwards This particular pig tail drain allows you to release the suture by unlocking the mechanism. www.ciamedical.com/cook-medical-g09705-each-ult8-5-38-25-p-5s-cldm-hc-dawson-mueller
@@mariekristellemata4089 thank you for the added information! Yes the drainage catheter can be unlocked by releasing the mechanism however often times we find that once these catheters have been in place for some time (especially when they are draining fluids etc) that the suture gets stuck in the hub if you simply unlock it in the traditional manner. This is why many of us actually cut the tubing to make sure the suture is released. It is important to realize that whether you cut the tubing or unlock the mechanism both will allow for air to enter retrograde into the catheter which is why the tubing is clamped.
Sometimes when I cut the tube and pull it out the thread gets left behind and I have to pull it out of the patient. Does this happen often with you?
@@cinderellaalmatrooshi797this has happened to me. I’m not sure what causes this.
I currently have one in my lower part of my stomach and to my urethra can I remove it myself if I don't require it anymore
Drain removal should be managed by medical professionals (both the decision of when to remove the drain and the actual removal).
thank you very much.
Isn’t there a small lever/lock that can be opened to release the suture? This way you don’t need to cut to release the suture or deal with the clamp. Also, do you have to have the patient hold their breath or engage in a valsalva maneuver when removing pigtail chest tubes or is that only reserved for the larger chest tubes? Thanks.
Yes but as the video explains if you were to open this lever air would be introduced into the pleural space as the seal is broken. Many providers do have the patent hold their breath or hum while the tube is being removed however it seems the most important maneuver is to have the xeroform ready to cover the hole immediately so you can apply an occlusive dressing.
Thank U doctor