Slurry talc pleurodesis

(The text is taken from the doctoral thesis of Dr Athanasios Kleontas)

Initially, a dissolution of 8gr talc powder (Steritalc by Boston Medical Products S.A., France) in 50ml of saline within a 60ml syringe, observing the necessary antiseptic conditions to ensure that it is completely dissolved and that there are no clumps within the solution (slurry talc). With the patient in an upright position and the Bulau on gentle suction, the patient is encouraged to take deep breaths and cough in order to drain most of the pleural fluid within the mediastinum.

We place the patient on a horizontal bed and guide him/her to be in a laterally supine position, with the affected hemithorax facing upwards. We sterilize the exit hole of the chest drainage tube from the chest wall and a sufficient length of tube (15-20cm) and in all the following steps we observe all necessary antisepsis conditions. We block the tube peripherally with one forceps and with a second forceps we block the tube centrally. Cut the pipe and reconnect it by adding a plastic connector, type luer lock. Withdraw the central clamp and inject 20 ml of a 2% lidocaine solution through the luer lock in order to prophylactically reduce possible pain during the injection of the talc. After about 5 min, after shaking the talc solution again, inject it through the luer lock into the tube. Finally, inject 20 ml of saline again in the same way to flush the walls of the tube with talc. Insert the stopper into the luer lock and move the blocking forceps centrally to the luer lock. Although controversial, we advise the patient to change the body position every 20-30 min in order to better disperse the talc within the pleural cavity. After 4-6 h we remove the blocking forceps and place the Bulau on suction for 24 h.