Axillary intercostal drain in traumatic haemopneumothorax.

During an 8-month period, 242 patients with thoracic injuries were admitted to one of the general surgical units at Baragwanath Hospital. Of these, 7.4% required surgical exploration, while 92.6% had pneumothorax treated conservatively by insertion of a single drain at the mid-axillary line in the 5th intercostal space. Of patients managed conservatively 76 had pneumothorax and 148 haemopneumothorax. There were no deaths in this series. All patients explored recovered well from the operation and were discharged after a mean period of 6 days. Of those with a pneumothorax managed conservatively full expansion of the lung was obtained in 98.7%. In 80% of the patients with haemopneumothorax, axillary intercostal drainage proved adequate treatment and resulted in prompt re-expansion of the lung. However, 6.8% of the patients in this group required further needle aspiration of the pleural cavity and in 2.7% a second drain was inserted for evacuation of residual blood. Eight (5.4%) patients were discharged with a small and insignificant residual haemothorax.