Chest drains may be broadly divided into two groups: 

  1. Small bore drains inserted via Seldinger technique 
  2. Large bore drains necessitating open insertion

The Seldinger technique has demonstrated a much lower risk of serious complications and lower pain scores when compared with large bore chest drains. A systematic review comparing the two methods in over 875 patients with pneumothorax found similar success rates but a significantly lower complication rate, shorter drainage duration and hospital stay in the small-bore drainage group. [3] However, in the context of trauma, haemothorax is likely and so a large bore drain with open insertion is preferred. Large drains may also be required to drain empyemas.

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