Is routine roentgenography needed after closed tube thoracostomy removal?

Background: Efficacy of chest radiograph protocol after tube thoracostomy t ube (CT) removal. Methods: Retrospective review (July of 1995 to July of 1996) of 141 patient s with CT followed throughout their hospitalization. Excluded patients died (23 patients) or had thoracotomy (13 patients) before CT removal. Results: A total of 105 patients had 113 CT removed (mean age, 36.9 years; Injury Severity Score = 23.4; CT duration, 5.0 days). protocol chest radiog raphs were performed on average at 7.9 and 22.1 hours, Recurrent pneumothor ax (RHPTX = new interpleural air) occurring in 12 patients (11%) and persis tent pneumothorax (PHPTX = same volume of interpleural air) occurring in 13 patients (12%) caused no clinical problems and were treated without tube r eplacement. Three patients had symptoms after removal; none had RHPTX. Two patients had clinical signs; one reaccumulated a hemothorax requiring CT re placement, the other improved without replacement. Conclusions: Clinically significant RHPTX/PHPTX after CT removal is infrequ ent. Signs not symptoms detect CT removal complications, At our institution , chest radiographs are obtained in a delayed manner from protocol and offe r no benefit over clinical assessment.