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“Every act of creation is first an act of destruction.”

Pablo Picasso, (1881-1973), Spanish painter, sculptor, printmaker, and ceramicist.

This is a frequent occurrence, be it traumatic, where the cause is obvious, or spontaneous, it is the manifestation of a lung lesion, allowing air to escape between the parietal and visceral pleural leaflets.

Since more than a century it is treated efficiently with a drainage system.

If principle of therapy receives general acceptance, precise procedure method remains obscure in the mind of many practitioners.

Forty years ago, appeared on the market fine tubings, easy to place securely without side effects.

Despite this fact some doctors resort still to complicated huge hoses, placed in dubious locations, with a dubious technique, completely unnecessary and outdated.

A bigger diameter pertains more risks for unexpected events, mostly bleeding.

Seldom is a broncho-pleural fistula the pathology to be treated, but on such an occasion even the vacuum cleaner of home would not be sufficient, as a colleague already stated 40 years ago. Here the gentle touch of a good thoracic surgeon is needed.

In all other cases fine tubing placed at the basis of the pleural space is all what is necessary, and sufficient time will do the rest, until the lesion seals.

There are still some physicians who misunderstand this simple logic, and also that drainage at the base in the pleural space sucks efficiently all air, despite the fact that you see it on the top on X-Rays.