title: Xpand chest drain: assessing equivalence to current standard therapy--a randomised controlled trial.
abstract: BACKGROUND
  Penetrating chest trauma is a leading cause of admission to South African emergency departments. The resultant pneumo-/haemothoraces are currently routinely treated by means of standard underwater bottle drainage. A South African company, Sinapi Biomedical, recently launched the Xpand chest drain. This device incorporates a one-way valve with a fluid reservoir and permits the detection of an air leak, as well as intrapleural pressure differences.
  
  
  OBJECTIVE
  To prove equivalence of the Xpand chest drain compared with standard underwater bottle drainage.
  
  
  METHODS
  In a non-blinded randomised control trial 67 patients with radiological proof of a pneumo- or haemothorax following penetrating chest trauma were divided into two groups. One group received standard underwater drain treatment and the other group had the Xpand chest drain inserted. Time from placement of drain to removal of drain (following radiological proof of resolution) was compared between the two groups.
  
  
  RESULTS
  The underwater drain group (N = 34) had drainage periods varying from 6 to 280 hours with an average of 81.47 hours, while the Xpand group (N = 33) had drainage periods varying from 13 to 151 hours with an average of 61.04 hours (p = 0.088).
  
  
  CONCLUSIONS
  Although there was a definite improvement in drainage time with the Xpand chest drain, the difference did not reach statistical significance. We have, however, proven that the Xpand chest drain is as effective as a standard underwater drain in treating the sequelae of penetrating chest trauma and therefore recommend it as an alternative to current standard therapy.
authors.affiliation: Department of Surgery, Tygerberg Hospital and Stellenbosch University, Tygerberg, W. Cape.
authors.forename: Charl
authors.initials: C
authors.lastname: Cooper
authors.forename: Timothy
authors.initials: T
authors.lastname: Hardcastle
mesh_terms: D000208:Acute Disease; D015505:Chest Tubes; D004322:Drainage / Q000295:instrumentation*; D006801:Humans; D013019:South Africa; D013898:Thoracic Injuries / Q000601:surgery* / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome; D014950:Wounds, Penetrating / Q000601:surgery* / Q000628:therapy