Some physicians use a trocar instead of dissection to place a chest tube. A tube, usually about as big around as a small finger is inserted in the pleural space. This tube is sutured into place and the skin around the tube is sutured. This tube is often hooked up to a suction device to facilitate drainage. The chest tube is left in place for several days until the fluid stops forming and drainage is minimal.
Complications are rare and include bleeding, infection, and a puncture in the lung.
Chest tube placement is somewhat uncomfortable and the site where the tube is placed remains uncomfortable until the tube is removed. Usually patients with a chest tube require systemic analgesics, either pills or injections, until the tube is removed. It may not be possible to drain all the fluid because of formation of fibrin septa, or partitions. Fibrin is a molecule that is a key component in the formation of blood clots. A chemical that breaks up fibrin, such as urokinase and streptokinase, can be instilled through a chest tube daily for several days.