1226 Audit of Chest Drain Stitch Removal in Thoracic Surgery Inpatients

This is the authors' abstract. We don't add key points for this paper.

Aim Most Thoracic Surgery inpatients undergo chest drain insertion during their hospitalisation. Some patients, however, experience extended stays or readmission after drain removal. Our departmental guidelines recommend removing stitches 5-7 days post-drain removal. This audit aims to evaluate and enhance our practice in this regard. Method This retrospective study included patients who remained as inpatients or were readmitted on day-7 following the removal of a chest drain that required stitches. The study was conducted in two cycles, the first cycle involved patients discharged from Thoracic Surgery between August 23rd and September 23rd. The second cycle took place six weeks after implementing an intervention that involved documenting the date of drain removal on the electronic medical records (EMR) with a recommended range for stitch removal. Results In the first cycle, there were 17 patients with 24 drains/stitches, with stitches remaining in place for a range of 6-44 days (median 10.5 days). In the second cycle, involving 14 patients with 22 drains/stitches, the range decreased to 4-18 days (median 7 days) post-intervention. Compliance improved from 20.8% to 54.5%. Importantly, we observed a reduction in incidents of bleeding, difficulty, or abandonment of stitch removal in the second cycle, as opposed to two cases in the first. Conclusions Timely removal of stitches following chest drain removal is essential for postoperative care, reducing the risk of complications associated with delayed removal. Our intervention significantly improved our practice. We recommend the continued implementation of EMR documentation as an effective means of enhancing patient care.