Chest tube manipulation strategies to ensure the patency of chest tubes and mediastinal tubes in patients after cardiac surgery have been common practice among both nurses and surgeons in a variety of healthcare settings. The purpose of this clinical review is to summarize the current scientific evidence in relation to the following clinical question: Does the practice of milking or stripping chest tubes increase patency and thereby prevent cardiac tamponade in postoperative cardiac surgery patients? A secondary question is this: Is milking or stripping associated with negative clinical consequences?

The search strategy for this clinical review included searching MEDLINE and CINAHL databases as well as hand searching bibliographies of clinical and research articles related to the care and manipulation of chest tubes. Key words included chest tubes, mediastinal tubes, chest tube manipulation, milking, and stripping. All types of evidence...

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