study does not have funding

The purpose of this pilot study is to determine whether chest tube suction duration, 24 hours vs 48 hours, prior to water seal affects outcome and length of stay after placement for traumatic pneumothorax.

Inclusion Criteria:

• Trauma service consult/patient
• Traumatic pneumothorax with chest tube placed within 0-24 hours of presentation and confirmation of adequate position
• Age >18
• Blunt or penetrating mechanism
• Chest tubes sizes 14 to 32Fr
• Chest tubes placed by residents on the trauma surgery service supervised by attending trauma surgeons or placed by the attending surgeon themselves
• Presence of single chest tube in one or both pleural cavities (single unilateral or bilateral tubes)
• Subjects with decision making capacity (DMC) who are able to provide written consent. DMC will be determined by the consenting physician through a teach back mechanism. Subjects must demonstrate understanding of the situation, appreciation of the consequences of their decision, reasoning of their thought process, and be able to communicate their wishes.

Exclusion Criteria:

• Age <18
• Pregnant patients
• Prisoners
• Mechanically ventilated in ICU for more than 24 hours while chest tube in place
• Chest tubes placed as part of, or present during, a thoracic operation
• History of surgery involving pleural cavity ipsilateral to chest tube
• Subjects with more than one chest tube on the ipsilateral side at any time prior to study chest tube removal
• Subjects with chylothorax or empyema
• Subjects with chest tubes that are withdrawn or removed unintentionally
• Subjects with known or suspected bronchial injury
• Subjects with bullous emphysema.