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.