Today our topic of discussion is Water Seal Chest Drainage.
Water Seal Chest Drainage
WATER SEAL CHEST DRAINAGE
Water seal chest drainage means that a column of water in a bottle seals off the atmospheric air preventing from entering the chest drainage tube and thereby in the pleural space. Water seal drainage system or so called “closed chest
drainage” is indented to allow air and flew to escape from the pleural space with each exhalation and to prevent that return flow with each inhalation. Water seal acts as a one way valve, permitting the unit directional flow of air and fluid out of the pleural space, but permitting none to enter from the drainage system.
Indications
- After thoracic or thoracoabdominal surgeries
- Chest injuries involving the pleura
- Spontaneous pneumothorax.
Objectives
- To remove air and fluid from the pleural space
- To re-establish normal negative pressure in the pleural space
- To promote re-expansion of the lungs which apposition and cohesion of the parietal and visceral pleura (Figs. 29.23 and 29.24)
- To restore the normal pulmonary ventilation
- To prevent the reflex (return flow) of air and fluid back into the pleural space from the drainage apparatus
- To prevent shifting of the mediastinum and collapse of the lung tissue by equalizing pressure on both sides.
Mechanism
- In a thoracic surgery the parietal pleura is incised and pleural space is opened
- Atmospheric air rushes into the pleural space and the lungs collapse
- When the chest wall is closed, the air is enclosed in the pleural space thus causing to have a pneumothorax in the operated site
- Additional air may continue to leak into the pleural space through the openings in the pulmonary pleural incision
- Trauma of surgery causes serosanguineous fluid to collect in the patient’s chest until healing occurs
- Negative pressure has been lost inside the space owing to pneumothorax.
- The body’s ability to absorb air from the pleural cavity is limited
- Therefore, a closed drainage must be established to remove the collecting fluid and air from the pleural cavity and to prevent additional air and fluid entering the pleural cavity
- A closed drainage system is used postoperatively to remove air and serosanguineous fluid form the pleural cavity.
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