THORACOSTOMY TUBES AFTER ACUTE CHEST INJURY - RELATIONSHIP BETWEEN LOCATION IN A PLEURAL FISSURE AND FUNCTION

OBJECTIVE. The purpose of this study was to determine how often chest tubes placed for acute trauma lie within a pleural fissure and to determine whether an intrapleural location influences outcome. SUBJECTS AND METHODS. Fifty-eight consecutive thoracostomy patients who had 66 chest tubes were studied prospectively. Tube location was determined from frontal and lateral chest radiographs. Outcome measures recorded included the following: duration of thoracostomy drainage, quantity of pleural fluid drained, need for further tubes; length of hospital stay, appearance an last chest radiograph before discharge, and need for surgical intervention. RESULTS. Thirty-eight (58%) of the tubes were placed within a pulmonary fissure, 15(23%) were posterior, nine (13%) were anterior, and four (6%) were in other locations. We found no significant difference in any of the outcome measures between tubes located in the fissure and other tubes. CONCLUSION. A large percentage of tubes placed for acute chest trauma lie within a pleural fissure. These tubes, however, appear to function as effectively as those located elsewhere in the pleural space.