Article Text

Download PDFPDF
Large-bore versus small-bore chest drains in traumatic haemopneumothorax: an international survey of current practice
  1. James Foley1,
  2. Steven Walker2,
  3. Edward Carlton1
  1. 1 Emergency Department, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
  2. 2 Academic Respiratory Unit Bristol, Bristol, UK
  1. Correspondence to Dr James Foley, Emergency Medicine, North Bristol NHS Trust, Bristol, BS10 5NB, UK; buffersjames{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Recent evidence has begun to challenge the use of large-bore surgical chest drains in the management of traumatic haemopneumothorax. Large-bore surgical drains are considered those >24F in diameter (requiring blunt dissection for insertion) while smaller drains (using a Seldinger needle over-wire technique) are those varying in size from <14F up to 20F.1 2 It has been reported that small-bore drains are more likely to be malpositioned and complicated by pneumonia, whereas large-bore drains have a higher risk of an additional pleural procedure and empyema. Based on largely retrospective data, the 2021 Eastern Association for the Surgery in Trauma management guideline conditionally recommended small-bore drains for stable patients with an isolated haemothorax.3 Subsequently, a small, randomised controlled trial (RCT) (n=119) of stable patients with isolated haemothorax reported that smaller drains are as effective as bigger drains for treating a haemothorax, with …

View Full Text


  • Handling editor Jason E Smith

  • Twitter @jamesfoley273, @DrsteveWalker, @EddCarlton

  • Contributors JF: Survey distribution, writing and data analysis. SW: Case vignette and image consultation, and survey design. EC: Survey conceptualisation and survey distribution.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.