Abstract
On the basis of analysis of 170 episodes of spontaneous pneumothorax, the following methods of treatment have been evolved: Collapse of 15 per cent treated by bed-rest. Collapse not exceeding 30 per cent in patients younger than 40 years treated with bed-rest; discharged in seven-ten days, if significant expansion was noted. Aspiration in addition to bed-rest significantly reduced expansion time in patients with more massive collapse. Primary intercostal drainage with suction is advocated for patients with massive collapse and chronic pulmonary disease, tension pneumothorax, hemopneumothorax and advanced age. Failure to expand after seven days is indication for open thoracotomy. Primary open thoracootomy is recommended for massive hemopneumothorax, trapped lung, third episode of collapse or a bilateral initial episode.
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