Chest trauma in a district hospital
Authors:
Jan Kačer
Authors‘ workplace:
Chirurgické oddělení, Nemocnice Kyjov
Published in:
Úraz chir. 20., 2012, č.2
Overview
Purpose of the study:
To analyse the group of patients with thoracic injury treated in a district hospital and to optimise the management of these patients.
Material and methods:
The medical records of 2177 patients treated for thoracic injury in outpatient or inpatient departments of Kyjov district hospital from 2007 to 2011 were retrospectively analysed. Based on these data we evaluated each type of injury, the number of hospital admissions and the final management including transport to the trauma center.
Results:
Total of 2153 patients with chest trauma were treated in our hospital. Of these patients, 1683 (77,31 %) were managed in OPD (outpatient deparment) and in 470 (21,59 %) admission was necessary. 24 patients (1,10 %) required referral to the trauma centre. The most frequent type of injury was the combination of the chest contusion and musculoskeletal trauma with the traumatic pneumohaemothorax. Pneumothorax and/or haemothorax was present in 133 hospitalised patients. In 57 of them the chest tube was inserted. Flail chest was diagnosed in 9 patients, in all of them the plate osteosynthesis for chest wall stabilization was performed. There was no urgent thoracotomy performed in our hospital during the observed period. In 3 patients, acute thoracotomy was necessary. The videoassisted thoracoscopy was performed in 13 patients with thoracic injury. In 9 of them retained haematoma was evacuated and the chest tube was inserted under visual control. In 1 patient VATS was employed in the treatment of posttraumatic empyema.
Conclusion:
Essentials of the chest trauma management are: immediate diagnosis, presence of appropriate medical staff and technical equipment, good cooperation between the specialists, reevaluation of the clinical status of the patient, consideration of all the treatment possibilities in a district hospital and therefore making a decision about the final treatment or referral to the nearest traumacentre.
Key words:
thoracic trauma, pneumothorax, haemotorax, chest wall stabilisation.
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Labels
Surgery Traumatology Trauma surgeryArticle was published in
Trauma Surgery
2012 Issue 2
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