The selective conservative management of small traumatic pneumothoraces following stab injuries is safe: experience from a high-volume XXXX service in South Africa.

@entity1 @entity130
OBJECTIVE: The selective conservative management of small pneumothoraces (PTXs) following stab injuries is controversial. We reviewed a cohort of @entity1 managed conservatively in a high volume @entity130 service in South Africa. MATERIALS AND METHODS: A retrospective review over a 2-year period identified 125 asymptomatic @entity1 with small PTXs measuring <2  cm on chest radiograph who were managed conservatively. RESULTS: Of the 125 @entity1 included in the study, 92  % were male (115/125), and the median age for all @entity1 was 21  years (19-24). Ninety-seven  per cent (121/125) of the weapons involved were knives, and 3  % (4/125) were screwdrivers. Sixty-one  per cent of all injuries were on the left side. Eighty-two  per cent (102/125) sustained a single stab, and 18  % (23/125) had multiple stabs. Thirty-nine  per cent (49/125) had a PTX <0.5  cm (Group A), 26  % (32/125) were >= 0.5 to <1  cm (Group B), 19  % (24/125) were >= 1 to <1.5  cm (Group C) and 15  % (20/125) were >= 1.5 to <2  cm (Group D). Three  per cent of all @entity1 (4/125) eventually required ICDs (one in Group C, three in Group D). All four @entity1 had ICDs in situ for 24  h. The remaining 97  % (121/125) were all managed successfully by active clinical observation alone. There were no subsequent readmissions, morbidity or mortality as a direct result of our conservative approach. CONCLUSIONS: The selective conservative management of asymptomatic small PTXs from stab injuries is safe if undertaken in the appropriate setting.
