Less pain with flexible fluted silicone chest drains than with conventional rigid chest tubes after cardiac surgery.

Drainage of the pleura and mediastinum after cardiac surgery is routinely achieved with rigid, wide-bore plastic drains.1 Although these drains are effective, they are also painful, particularly during removal,2 and they may cause damage to bypass grafts, impair ventilation, and cause cardiac arrhythmias.3 Flexible fluted silicone drains may be just as effective.4 Because of the fluted design, smaller sizes can be used without any reduction in the effective drainage capacity. The small size and flexibility may cause less pain, interfere less with the heart and surrounding structures, and result in fewer drain site infections. To investigate these potential benefits and to establish the efficacy of these drains, we designed a prospective, randomized trial that compared the two types of drain.