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Learning from Lister

Drainage tubes

Photograph of three drainage tubes with loops of thread tied to the endsThree copies of Lister’s abscess drainage tubes, invented 1871, made for the Lister centenary exhibition, 1927. Science Museum/SSPL. Antiseptic surgery had implications for all surgical procedures. Lister was the first British surgeon to use indiarubber drainage tubes. These had originally been introduced by the French surgeon Edouard Chassaignac in 1859, but their use was unknown in Britain. Chassaignac’s drain was a small indiarubber tube with lateral holes to admit the discharge from the abscess.

Lister modified Chasaignac’s design by using tubes of larger bore when they were needed and in cutting the outer end in such a way that it was always flush with the surface of the skin, in order to prevent buckling and obstruction of the tube through friction with the dressing. Tubes varied in thickness from that ‘of a cow-quill to that of the little finger’ (Fisher) and their openings were half the width of the tubes themselves. Lister attached loops of silk to the outer end to keep the tube in position while the dressing was firmly bandaged over it.

Glass drainage tubes had posed a number of risks for patients: irritation and soreness of the skin; herniation; and the introduction of septic elements from outside. Indiarubber tubing alleviated these problems to a large extent because the tube could be shortened as the wound closed from the inside. Lister commonly kept the tubes in the wound for three or four days. For years it was generally accepted that Lister improvised indiarubber tubing through adapting part of a chloroform inhaler at Balmoral in 1871 when draining Queen Victoria’s abscess. However, it now appears that he had hit upon the idea several years earlier.

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