Injuries of the chest wall.

Abstract

Injuries to the chest may be penetrating or nonpenetrating, depending on whether a wound through the chest wall has occurred. The penetrating wounds are divided into closed penetrations and sucking wounds. Nonpenetrating injuries, resulting from a blow to, or severe compression of, the thorax, usually involve fractures of the bones of the chest wall and shoulder girdle. A penetrating wound of the chest may involve injury to one of the intercostal or internal mammary vessels, the lungs, the heart, or great vessels. Sucking wounds require prompt closure by any means. Occlusive dressings should be used until adequate surgical facilities become available. Large traumatic defects in the chest wall may be closed by means of periosteal or perichondrial flaps or by steel wire mesh. The associated pneumothorax or hemothorax must be treated by appropriate measures. Nonpenetrating injuries of the chest are steadily increasing in incidence due to the present modes of