Traumas are the leading cause of death in the first four decades of life and are mostly caused by traffic accidents ( 1). Keywords: Chest trauma chest drain thoracotomy hemothorax pneumothorax Large randomized trials are still needed to assess and standardized the role of new tools and procedures in the thoracic trauma setting. In selected patients, minimally invasive techniques can be performed. Anterolateral thoracotomy is usually performed in this setting, but also clamshell or hemi-clamshell approach can be used. Penetrating traumas more likely require surgical exploration compared to blunt trauma. Surgical exploration after thoracic trauma is rare, accounting for less than 3% of traumas. Although it is a common procedures, experience and training is needed to avoid complications which might be even lethal. Although large-bore chest drains have been traditionally used in case of haemothorax, recent evidences seem to question this routine, showing good performances of small-bore and pig tail drains. In particular, chest drain placement is required in case of pleural disruption causing haemothorax, pneumothorax or haemopneumothorax. Nevertheless, thoracic traumas only seldom require invasive procedures. Abstract: Traumas are the leading cause of death in the first four decades of life.
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