Thoracic Battle Injuries in the Lebanon War: Review of the Early Operative Approach in 1,992 Patients

Zakharia, Alex T.

doi:10.1016/s0003-4975(10)60029-x

Cited by 30 publications

(13 citation statements)

References 20 publications

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“…The incidence of patients with penetrating chest injuries requiring thoracotomy constitute 5.8% to 71.0% in the literature of all patients [2,6,[11][12][13][14][15][16][17][18]. Thoracotomy was required in 8.1% of our patients.…”

Section: Discussionmentioning

confidence: 99%

Penetrating Chest Injuries: Unusually High Incidence of High‐velocity Gunshot Wounds in Civilian Practice

et al. 1998

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Penetrating chest injuries are a challenge to the thoracic or trauma surgeon. Penetrating thoracic trauma, especially that due to high-velocity gunshot wounds, is increasing at an alarming rate in our region. We report our experience with penetrating chest injuries mainly due to high-velocity gunshot wounds. During a period of 6 years we retrospectively reviewed the hospital records of 755 patients admitted to the Department of Thoracic and Cardiovascular Surgery, Dicle University School of Medicine, with the diagnosis of penetrating thoracic trauma. The mean age was 27.48 years, and 89-8% were male. The causes of penetrating injury were stab wounds in 45.3% and gunshot wounds in 54.7%. About 30% of the wounds were due to high-velocity gunshots; and among the gunshot wounds 56.2% were due to high-velocity shots. The most common thoracic injury was hemothorax (n = 190) followed by hemopneumothorax (n = 184). Isolated thoracic injuries were found in 53% of the patients. Nonoperative management was sufficient in 92% of the patients. Thoracotomy was performed in 8.1%. The mean duration of hospitalization was 11.2 days. The mean injury severity score (ISS) was 20.17 +/- 13.87. The morbidity was 23.3% and the mortality 5.6%. Fifty percent of all deaths were due to adult respiratory distress syndrome. Altogether 17% of patients with an ISS > 25 died, whereas only 0.9% of those with a score < 16 died. The mortality due to firearms was 8.95%. We concluded that in civilian practice chest tube thoracostomy remains by far the most common method of treating penetrating injury to the chest. The easy availability of high-velocity guns will continue to increase the number of civilians injured by these weapons.

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Section: Discussionmentioning

confidence: 99%

Penetrating Chest Injuries: Unusually High Incidence of High‐velocity Gunshot Wounds in Civilian Practice

et al. 1998

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“…This percentage is higher in comparison to findings in comparable studies. This is most likely due to the severity of the injury [8,9]. In areas such as war zones or areas with civil disorder, explorative thoracotomy rates can reach 80 % of the cases [8,10].…”

Section: Discussionmentioning

confidence: 99%

Outcome of penetrating chest injuries in an urban level I trauma center in the Netherlands

Heus

Mellema

Giannakópoulos

et al. 2015

Eur J Trauma Emerg Surg

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“…These solid organs offer greater resistance to passage of a missile and thus absorb more kinetic energy, causing more destruction and devitalization as the missile passes through them. However, reports on civic unrest in Belfast [9] and military operations in Lebanon [1] and Iraq [10] indicate that 71% to 80% required thoracotomy and the remaining 20% to 29% were managed by tube thoracostomy. The magnitude of war and civic unrest injuries caused by firearms (rifles or machine guns) is quite different from civilian handgun injuries.…”

Section: Discussionmentioning

confidence: 99%

Penetrating chest wounds: 24 years experience

Mandal

Sanusi

2001

World j. surg.

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Thoracic and thoracoabdominal penetrating wounds are frequently encountered in urban medical centers in the United States. This study was undertaken to determine the clinical characteristics and in hospital outcome of these injuries. This was a longitudinal, nonblinded study using the established standard of care of patients with penetrating chest trauma. It consists of an analysis of a consecutive series of 3049 patients treated at one trauma center between April 1972 and March 1996. There were 1347 stab wounds and 1702 gunshot wounds. Antibiotic prophylaxis was administered to patients who underwent laparotomy or thoracotomy or who had lung contusion with hemoptysis (41.6%, 1296/3049). Of 3049 patients, 196 had cardiac injuries. All of them underwent thoracotomy, and the mortality was 21.9%. In contrast, among 2853 patients without cardiac injuries, only 257 (9%) required thoracotomy; the mortality in this group was 1.5%. Patients with thoracoabdominal injuries (899/3049) had a mortality of 4.3% compared to 2.1% among those who had isolated chest injuries. The overall mortality was 2.8%. Of 1702 patients with gunshot wounds, 85 (5%) sustained transaxial injuries, with an overall mortality of 36.5%. The complication rate among the survivors was 6% with only 2.5% being infectious. We conclude that the mortality for noncardiac penetrating injuries of the chest is low. The presence of associated abdominal injuries increases the mortality twofold. More than one-third of the patients with transaxial wounds die. Gunshot wounds of the heart result in higher mortality than stab wounds to the heart. The infection rate is low.

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Thoracic Battle Injuries in the Lebanon War: Review of the Early Operative Approach in 1,992 Patients

Cited by 30 publications

References 20 publications

Penetrating Chest Injuries: Unusually High Incidence of High‐velocity Gunshot Wounds in Civilian Practice

Penetrating Chest Injuries: Unusually High Incidence of High‐velocity Gunshot Wounds in Civilian Practice

Outcome of penetrating chest injuries in an urban level I trauma center in the Netherlands

Penetrating chest wounds: 24 years experience

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