Chest drain insertion, medically known as thoracostomy, is a vital medical procedure designed to treat conditions where various substances accumulate in the pleural space. This space is the thin potential gap located between the lungs and the inner chest wall. In a healthy state, this space contains a minimal amount of lubricating fluid, but in various disease states, significant amounts of fluid, blood, or air can accumulate there. This accumulation exerts constant pressure on the lung, preventing it from expanding properly during inhalation and leading to symptoms such as significant shortness of breath, chest pain, and in severe cases, impaired gas exchange and blood oxygenation.

The main goal of the procedure is the efficient drainage of the accumulated material to allow the lung to return to its normal volume and provide immediate relief from the patient's distress. The procedure is suitable for a variety of patients, including those suffering from pneumothorax (collapsed lung) due to trauma or spontaneously, patients with pleural effusion (fluid around the lungs) due to heart failure or malignancies, as well as in cases of pus infection (empyema) or bleeding into the chest cavity (hemothorax). The action is usually performed under local anesthesia of the insertion area on the chest wall. To ensure maximum safety and accuracy in insertion, the performing physician often uses advanced imaging aids such as ultrasound or CT, which assist in locating the optimal position between the ribs. After making a small incision in the skin, a flexible tube (catheter) is inserted into the pleural space. This tube is connected to an external closed drainage system, which usually operates based on gravity or gentle suction, for removing the excess content.