[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.