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In 2013 after a subsequent review, they again could find no evidence the improvised dressing was “effective either in reversing the respiratory difficulty caused by an open pneumothorax or in preventing the conversion of an open pneumothorax into a tension pneumothorax.” 7 Although there is experimental animal literature that vented (compared to non-vented) commercial chest seals do work to prevent an open pneumothorax with ongoing air leak from becoming tension pneumothorax, 8,9,10 there still is no clear evidence that an isolated open pneumothorax needs to be sealed

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