Comparative effectiveness of suction versus water seal following tube thoracostomy in traumatic pneumothorax and hemothorax
This updated meta-analysis evaluated the impact of suction versus water seal (no external suction connected) management following tube thoracostomy for traumatic pneumothorax and hemothorax. Across five randomized trials, suction was associated with shorter chest tube duration, reduced hospital length of stay, and higher rates of complete lung re-expansion compared with water seal management. No significant differences were observed for recurrent pneumothorax, re-intervention, or retained hemothorax, although these outcomes were limited by low statistical power. While the findings suggest that suction may improve key chest drain management outcomes after traumatic chest injury, the evidence is weakened by the high risk of bias across all included studies, highlighting the need for larger, well-designed randomized trials.
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