Conservative treatment of primary spontaneous pneumothorax – A Post Implementation Study

Primary spontaneous pneumothorax (PSP) is a significant global health problem affecting adolescents and young adults. Current management is variable, with sparse evidence from randomised controlled trials to guide treatment.1 Current guidelines emphasise the importance of intervention, which involves insertion of a chest drain, hospital admission, and thoracic surgery in some.2,3 This approach has recently been questioned4 and there is evidence to suggest that conservative management without intervention is effective and safe.5,6 The risk of recurrence (23-27% in the first year7-10) may also be lower with conservative treatment because of better healing of the lung defect during slow re-expansion of the lung. Monash University has recently been involved in an international first a conservative versus invasive management in a multicentre randomised controlled trial that was the largest study of PSP ever undertaken. This project would look at implementing the findings of this study at Monash Health.