Stable Penetrating Chest Trauma

Annotation for Point D

Larger pneumothoraces (classically those that are immediately apparent on the first plain CXR) generally are drained. In the absence of other indications, small-bore tubes or a range of pleural catheters (8.5-16 Fr) are acceptable.14,38 The catheter tubes are easy to place, less painful, and as effective as the more traditional tubes in one series.39 Stable patients who have had previous thoracotomy, chronic lung disease (such as emphysema), and/or pleural inflammation (e.g., chronic bronchitis) may be better managed by image-directed catheter drainage to avoid areas of adhesions.