The analysis of 89 patients that performed tube thoracostomy by general surgeons

Abstract

Objective: Death due to thoracic trauma accounts for 20% of all trauma deaths. The aim of this study was to discuss the approach applied by general surgeons to thoracic trauma in our center. Material and Methods:A total of 89 patients (82 male, 7 female; mean age: 26.8 years; range: 7 to 77 years) with thoracic trauma who were admitted to the emergency department and underwent thoracostomy performed by general surgeons between January 2008 and December 2013 were retrospectively analyzed.Results: Penetrating trauma was found in 61 patients (68%); this was the most common cause of thoracic trauma. Pneumothorax, the most common clinical sign, was found in 57 patients (64%). Abdominal pathologies, the most common concomitant extra-thoracic pathologies, were found in 17 patients (19%). Fifteen patients (17%) underwent laparotomy due to intra-abdominal organ injuries. Splenic trauma and diaphragmatic injury were detected in five patients. Complications were seen in two patients (2.2%): one had an air leak and one had persistent pneumothorax. Three patients with multi-trauma died in the early period due to additional pathologies. No mortality was seen in any patient due to thoracic trauma. Conclusion:All general surgeons should be highly familiar with approaches to thoracic trauma, and necessary interventions should be performed in emergency situations. It is also essential to correctly identify patients who require timely and appropriate referral to a tertiary center to reduce the rates of mortality and morbidity.

Wie oft braucht es eine Thoraxdrainageneinlage beim Thoraxtrauma des schwerer Verletzten – und wann mehr?

“…Unfall‑)Chirurgen, welche eine thoraxchirurgische Reinterventionsnotwendigkeit aufgrund einer Fehleinlage bedingt hätte. Dies deckt sich mit internationalen Angaben zum Unterschied der Komplikationshäufigkeit nach Thoraxdrainageneinlage je nach operierender Fachdisziplin (s. unten; [ 18 ]). Detaillierte Fallobservationen bez.…”

“…In der Literatur finden sich disziplinenabhängige Komplikationsraten nach Drainageneinlage von 6–7 % bei Thorax- bzw. Allgemeinchirurgen, im Vergleich zu 13 % bei Internisten und 23 % bei Notärzten (23 %; [ 18 ]).…”