Our Experience in the Treatment of Severe Thoracic Trauma.
AJTES Vol 3, No 1, July 2019
Full Text PDF

Keywords

penetrating thoracic injury
blunt trauma of chest wall
surgery treatment

How to Cite

Gradica, F., Xhemalaj, D., Dogjani, A., Lisha, L., Argjiri, D., Skenduli, I., Buci, S., Mici, A., Osmanaj, S., Demko, V., Ruci, S., Cani, A., Kokici, F., Vata, Y., & Bozaxhiu, D. (2019). Our Experience in the Treatment of Severe Thoracic Trauma. Albanian Journal of Trauma and Emergency Surgery, 3(1), 256-261. https://doi.org/10.32391/ajtes.v3i1.20

Abstract

Background: Severe thoracic trauma is main cause of deaths in US about 10-20 % of deaths. Causes of severe thoracic Trauma are :Penetrating trauma,Gunshot wounds,Stab wounds ;Lower mortality rate   less massive, less multiorgan injury Gunshot wounds on the chest is the most lethal – 50% .Only 7-10% undergoes hospitalization prior to death .Death due to heart & great vessel injuries.

Aim of study: Analyses of patients with Severe Thoracic Trauma ,Initial Evaluation and Management analyses of our cases period of time 2004-2017 treated in thoracic surgery service

Material and methods: 95 patients are treated in our hospital during July  2004- July 2017 timeframe. Male to  female was  ratio 3:1. Age of presentation  9-71 years old, mean age presentation 49  years old. Blunt chest wall trauma 36 (38%) and  penetraiting  chest wall trauma 59 (62%) patients. Ribs  and sternal fractures , two  or  more costal fractures in 15 (15.7%) patients  (flail chest 7 patients );unilateral pneumothorax  34 (35.7%) patients ,bilaterally  pmeumothorax 10 (10.5%) patients;massive hemothorax 12 (12.6%) patients , pneumomediastin et subcutaneous emphysema 6 (6.31%) patients Hammans syndrome, lung contusion and parenchimal pulmonary hemathoma in 15 (15.7%) patients; bronchial rupture 2 (2.1%) patients ,tracheal rupture 1 (1%) patient.

Results: Only  medical treatment in 22 (23%) patients,unilateral pleural tub drainage 42 (44%) patients, bilateral chest drainage 18  (18.9%) patients ;thoracotomy  in 29(30.5%) patients ,wedge resection,lung hemostasis and aerostasis from lung lacerations, bronchial  lobar  rupture left lower lob 1 (1%) patient, bilateral thoracotomy 3 (3%) patients, clamshell  incision in 1 (1%)  patient;,thoracoabdominal approach 2 ( 2%) patients. flail chest wall  stabilization 7 (7.3%) patients by vicryl suture  ,steel wire suture 3(3%)patients,titanium plate 3(3%) patient.By VATS are treated 2(2.1%) patients.Mean hospital stay was 11 days (average 3-36 days).Morbidity rate in 6 (6.3%)patients , mortality was on 5  (5%)patients.

Conclusion: Most common injury locations was  lung and chest wall and  less common abdominal and cranial trauma.Surgical and intensive treatment are very important and with low mortality rate.

https://doi.org/10.32391/ajtes.v3i1.20
Full Text PDF

References

Demirhan R, Onan B, Oz K, Halezeroglu S: Comprehensive analysis of 4205 patients with chest trauma: a 10- year experience. Interact Cardiovasc Thorac Surg 2009, 9(3):450-453.

O’Connor JV, Adamski J: The diagnosis and treatment of noncardiac thoracic trauma. J R Army Med Corps 2010, 156(1):5-14

Mefire AC, Pagbe JJ, Fokou M, Nguimbous JF, Guifo ML, Bahebeck J: Analysis of epidemiology, lesions, treatment, and outcome of 354 consecutive cases of blunt and penetrating trauma to the chest in an African setting. S Afr J Surg 2010, 48(3):90-93.

Lema MK, Chalya PL, Mabula JB, Mahalu W: Pattern and outcome of chest injuries at Bugando Medical Centre in Northwestern Tanzania. J Cardiothorac Surg 2011, 6:7.

Liman ST, Kuzucu A, Tastepe AI, Ulasan GN, Topcu S: Chest injury due to blunt trauma. Eur J Cardiothorac Surg 2003, 23(3):374-378. Al-Koudmani et al. Journal of Cardiothoracic Surgery 2012, 7:35 http://www.cardiothoracicsurger y.org/content/7/1/35 Page 6 of 7

Hanafi M, Al-Sarraf N, Sharaf H, Abdelaziz A: Pattern and presentation of blunt chest trauma among different age groups. Asian Cardiovasc Thorac Ann 2011, 19(1):48-51.

Zargar M, Khaji A, Karbakhsh Davari M: Thoracic injury: a review of 276 cases. Chin J Traumatol 2007, 10(5):259-262.

Yalçinkaya I, Sayir F, Kurnaz M, Cobanoğlu U: Chest trauma: analysis of 126 cases. Ulus Travma Derg 2000, 6(4):288-291.

Demirhan R, Küçük HF, Kargi AB, Altintaş M, Kurt N, Gülmen M: Evaluation of 572 cases of blunt and penetrating thoracic trauma. Ulus Travma Derg 2001, 7(4):231-235.

Segers P, Van Schil P, Jorens P, Van Den Brande F: Thoracic trauma: an analysis of 187 patients. Acta Chir Belg 2001, 101(6):277-282.

Kulshrestha P, Munshi I, Wait R: Profile of chest trauma in a level I trauma center. J Trauma 2004, 57(3):576- 581.

Pamerneckas A, Pijadin A, Pilipavicius G, Tamulaitis G, Toliusis V, Macas A, Bilskiene D, Blazgys A: The assessment of clinical evaluation and treatment results of high-energy blunt polytrauma patients. Medicine (Kaunas) 2007, 43(2):137-144.

Cakan A, Yuncu G, Olgaç G, Alar T, Sevinç S, Ors Kaya S, Ceylan KC, Uçvet A: Thoracic trauma: analysis of 987 cases. Ulus Travma Derg 2001, 7(4):236-241.

Veysi VT, Nikolaou VS, Paliobeis C, Efstathopoulos N, Giannoudis PV: Prevalence of chest trauma, associated injuries, and mortality: a level I trauma center experience. Int Orthop 2009, 33(5):1425-14 15. 33.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.