Penetrating Chest Injuries in Children

Abstract

A consecutive series of 14 Vietnamese children aged 2 to 16 years with war-related penetrating thoracic injuries is presented. The children were treated by the author aboard U.S. Navy hospital ships in a one-year period from October, 1969, to September, 1970. Seven had sucking chest wounds and 9 had intrapulmonary hematomas on admission. Three had associated abdominal penetration, and 2 had craniocerebral injury. Three had sustained gunshot wounds, and 11 had missile injuries. Emphasis is placed upon resuscitation using large central venous catheters; rapid pulmonary reexpansion using large-bore polyvinyl chest tubes; debridement and primary closure of chest wounds; concurrent treatment of associated injuries; and vigorous treatment for and prevention of pulmonary complications. Ten children had an uncomplicated recovery from their thoracic injuries; 4 had chest complications. There were no deaths in this series, nor any chest wound infections, residual bronchopleural fistulas, clotted hemothorax, empyema, or excavating hematoma.