Articles: thoracostomy-instrumentation.
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Pneumothoraxes, whether spontaneous or iatrogenic, frequently require drainage. Although the recent trend has been toward a catheter-based approach, many thoracic surgeons continue to use chest tubes. ⋯ After disappointing experience with pneumothorax catheters, we have modified a central line to use in lieu of a pneumothorax kit. We have found this technique to be effective, safe, reliable, and inexpensive.
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To determine whether the Mac-technique test can detect kinking of the chest tube upon thoracostomy tube placement. ⋯ On the basis of this study, a positive Mac-technique test is useful to detect chest tubes that are likely to be kinked after insertion and before securing.
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Case Reports
Bronchocutaneous fistula after chest-tube placement: A rare complication of tube thoracostomy.
Bronchocutaneous fistula is a pathologic communication between the bronchus, pleural space, and subcutaneous tissue. It can occur as a complication of positive pressure ventilation and pneumonectomy. Diagnosis is made by imaging studies. ⋯ Computed tomography scan revealed a fistulous tract from the bronchus to the skin at the site of the original chest tube, and chest x-ray film revealed a subcutaneous fistulous air tract in the lateral chest. It is usually an acquired condition; congenital bronchocutaneous fistula is rare. We report a case of bronchocutaneous fistula after chest-tube placement.
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Insertion of chest drain is always a life saving procedure in emergent conditions. Especially in crowded traffic accidents more than one patient has brought to the emergency service. ⋯ We have no complications related to use of this technique. We concluded that use of laparoscopic trocars in chest tube insertion in emergency conditions is an safe and rapid procedure.
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Randomized Controlled Trial Comparative Study Clinical Trial
Chest tube removal: end-inspiration or end-expiration?
Recurrent pneumothorax is the most significant complication after discontinuation of thoracostomy tubes. The primary objective of the present study was to determine which method of tube removal, at the end of inspiration or at the end of expiration, is associated with a lesser risk of developing a recurrent pneumothorax. A secondary objective was to identify potential risk factors for developing recurrence. ⋯ Discontinuation of chest tubes at the end of inspiration or at the end of expiration has a similar rate of post-removal pneumothorax. Both methods are equally safe.