The mythology of the chest drain

The underwater seal chest drain (UWSD) as we know it came into surgical practice in the late 1880’s. It is because of the UWSD that modern Thoracic surgery developed. Prior to the UWSD the only practical surgery was on empyema where it was possible to operate without the lung collapsed.

A chest drain is a surgical drain but differs from other drains in that it is placed into the negative pressure cavity, the thorax. As such it needs a valve in the system.  Without a functioning valve there are potentially dire consequences.


Chest drains

No drain in medicine is surrounded with as much wonder and mythology as the humble chest drain .

Inserting a chest drain is a skilled surgical procedure, even though most are inserted by non-surgeons. The down side of that is that most drains are placed inadequately and have to be re-positioned. The up side of that is that it keeps Thoracic surgeons in business


Drainage systems


Emergency insertion

Trocars and clamps




When to call a thoracic surgeon