- Place chest drains for apical and posterioi pleural drainage. Our preference is to use a 28-Fr tube thoracostomy for anterior apical drainage and a posterior channeled silicone drain. Reapproximate the ribs with no. 2 braided polyglactin sutures passed through pilot holes drilled into the lower rib in order to reduce intercostals neuralgia. Close the remaining muscular and soft tissue in layers with running absorbable suture and close the skin.