Thoracotomy for thoracic trauma

Overview

Thoracic trauma along with cranial trauma is one of the major traumatic causes of mortality, especially in young persons. The authors analyse retrospectively a group of 42 injured patients, who underwent acute posttraumatic thoracotomy at the Clinic of Surgery at the University Hospital of Plzeň during the period 2000–2004. The youngest operated male was 10 years old, the oldest patient 73 years, the average age 33,1 years. The youngest female was 26, the oldest 56 years, the average age in women 47,2 years. Blunt trauma occured in 30 cases (71,4 %) and penetrating trauma in 12 cases (28,6 %). The cause of injury was traffic accident in 31 cases (73,2 %), attempted suicide in 5 cases (4 times by a sharp object, once a fall), and 3 other causes. Indications for emergency thoracotomy are mainly crucial directly lifethreating bleeding. According to the authors indications were: 1.continual bleeding, blood drainage > 1000 ml initially, or > 200ml/h during the first 5 hours from one side of the thorax, 2. serious persistent air leak from the thoracic drain, 3. ventilation failure due to serious bleeding into airways and 4. compression of vena cava superior by haemomediastinum or emphysema.

Key words:
thoracotrauma, polytrauma, indications for thoracotomy.