A Reading on Chest Tube Insertion

A Reading Presented to 

The faculty of Nursing Department
Monica Aguirre, RN

In Partial fulfilment of the

Requirements in NCM-217

By:

Karl Angelo Montano, Stn

BSN 3B

February 21, 2021

“Comparison of Three Practices for Dressing Chest Tube Insertion
Sites: A Randomized Controlled Trial”

Bibliography
Gross, S. L., Jennings, C. D., & Clark, R. C. (2016). Comparison of three
practices for dressing chest tube insertion sites: A randomized
controlled trial. Medsurg Nursing, 25(4), 229-231,250. Retrieved from
https://www.proquest.com/scholarly-journals/comparison-three-
practices-dressing-chest-tube/docview/1812894973/se-2?
accountid=31259

Summary
Chest tube dressings are used to secure the tube, prevent air leakage
into the pleural space, provide a barrier to prevent infection, and absorb
drainage. Reviewers identified a need for evidence to guide dressing practice
for their patients with chest tubes. The study investigated outcomes
associated with three different practices: dry sterile dressing, petroleum-
saturated gauze dressing, and no dressing. Literature Review A literature
search using databases Pubmed, Dynamed, Ebscohost, CINAHL, and
Medline was conducted using key words chest tube dressing, Vaseline
dressing, gauze dressing, occlusive dressing, and Tegaderm dressing for
publications from 2009 to 2014. Jones conducted a randomized controlled
trial on patients with chest tubes to compare outcomes for standard dry gauze
with a clear transparent dressing.
In the study facility, the practice for chest tube dressing was PSD
covered with occlusive foam tape. A convenience sample of 59 patients was
determined to be adequate to allow description of outcomes and trends
associated with each dressing type, and to use this information to make
evidence-based recommendations regarding chest tube dressings for the unit.
The principal investigator used a random numbers table to assign subjects to
the dressing practice groups and communicated group assignment to nurses
in the operating room to ensure appropriate dressing application. The surgical
team applied the appropriate study dressing to the subject in the operating
room following chest tube placement, or the patient received no dressing
according to the randomization assignment. For the outcome of pain with the
dressing in place, no statistically significant difference was found between the
PSD and the DSD. However, a statistically significant difference was found
between the dressings in pain with removal.
The lack of statistically significant differences in the outcomes indicates
the dressings are equivalent in skin integrity, incidence of air leaks, and pain
with the dressing in place. No data are available to indicate a
petroleumsaturated dressing was superior to a dry gauze or no dressing in
terms of skin integrity or incidence of air leaks. While a statistically significant
difference was not found in skin integrity and inflammation among the
dressing types, authors observed patients with no dressing experienced
inflammation more frequently than those with PSDs and DSDs. Additional
research needs to be conducted with a larger group of patients to determine
best practice for chest tube dressings. Recommendations for Future
Research Neither of the dressing options in the study allowed clinicians to
visualize the chest tube insertion site directly. These new dressings do not
provide an occlusive seal if the patient is experiencing an air leak, an
important consideration in dressing selection.

Reaction

The article is about comparison of three practices in chest tube dressings. A

chest tube can help drain air, blood, or fluid from the space surrounding your
lungs, called the pleural space. Chest tube insertion is also referred to as
chest tube thoracostomy. It’s typically an emergency procedure. It may also
be done after surgery on organs or tissues in your chest cavity. During chest
tube insertion, a hollow plastic tube is inserted between your ribs into the
pleural space. The tube may be connected to a machine to help with the
drainage. The tube will stay in place until the fluid, blood, or air is drained from
your chest.

I was amazed by the article that I have read because they find a new
way on how to efficiently dress chest tube insertion site. Chest tube dressing
for me is very important because if it is correctly done it can lessen the
infection that can lead to respiratory infection that will cause death. I hope that
in the future researches there will be more ways on how to dress wound sites
effectively.

For nursing implication, Some clinical difference appears to exist

among PSD, DSD, and ND options in terms of skin integrity/ inflammation.
The authors observed patients with no dressing experienced inflammation
more frequently than those with PSDs and DSDs.