[Drainage technique in thoracic trauma and pneumothorax].
In most cases of perforating thoracic injury, thoracotomy is performed immediately. In blunt thoracic trauma with pneumothorax, the drain--24-32 Ch--is inserted via a minithoracotomy on the anterior/intermediate axillary line in the fifth intercostal space. In spontaneous pneumothorax, a trocar is inserted at the same site and the lung inspected thorascopically for so-called ELCs. The drain--in this case 24 Ch--is then directed dorsally into the dome of the pleura, this being essential for optimal evacuation of air and secretion. So-called Pleuracaths are unsuitable because they are 50% coated with fibrin. Drainage on the medioclavicular line in the second or third intercostal space is inappropriate for various reasons. Emergency management of tension pneumothorax comprises pressure relief via a cannula.
Kaiser
D
D
Abteilung für Thoraxchirurgie, Zentralklinik Emil von Behring, Zum Heckeshorn 33, 14109 Berlin.
D015505:Chest Tubes; D004322:Drainage / Q000379:methods*; D006801:Humans; D011030:Pneumothorax / Q000601:surgery*; D013898:Thoracic Injuries / Q000601:surgery*; D014949:Wounds, Nonpenetrating / Q000601:surgery*; D014950:Wounds, Penetrating / Q000601:surgery*