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Such pain can normally be avoided if you have the following procedure.
1. See to it that the fastening suture is removed.
2. Set the vacuum to zero (usually by cutting the drainage catheter or by clamping off the inlet tubing close to the connector and for some time to let the pressure equalise)
3. If the catheter seems to be sticking, twist the catheter clockwise and anti-clockwise round its own axis a few times.
4. Ask the patient to take a deep breath and hold it at the same time as the catheter is removed cautiously (compare the withdrawal of a foley catheter).
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