Penetrating injuries of the pleural cavity

Abstract

Two hundred and fifty one cases of penetrating wounds of the chest were studied prospectively. Clinical evidence is presented to show that: (1) basal intercostal drains are adequate to remove both air and fluid from within the pleural cavity; (2) frequent chest radiographs are unnecessary and intercostal drains may be removed on clinical grounds alone; (3) long term antibiotic prophylaxis is unnecessary; (4) eight per cent of those undergoing initial observation will develop a delayed haemothorax or pneumothorax of sufficient size to require drainage; (5) subcutaneous emphysema is of no prognostic significance in the symptomless patient with minimal intrapleural damage on admission; and (6) outpatient follow up is not required.