Abstract
Penetrating chest injuries are the most frequent causes of serious demage and death in wounded indivisuals. In reports from the last wars where wounds caused by high velocity projectiles predominated, thoracotomies were perfomed in about 15% of the wounded individuals, mostly encompassing injuries of the heart and great vessels, accomanied by massive bleeding that could not be resolved by chest tube insertion. This retrospective analysis was performed on the medical records of 477 patients tretaed for isolated penetrating chest injuries in Department of Thoracic Surgery Clinical Center of the University in Sarajevo between april 1992 - june 1995. We analised the ways of their menagement with special view on pleural drainage, indication for this method and results of treatment. 398 (83,4%) wounded individuals have been treated with pleural tube inserting as definitive mesaure and for the urgent thoracotomy there were 79 (16,6%) patients left. Average hospital treatment in wounded drained patients was 7,68 days. With shrapnels there were 357 (74,84%) wounded individuals, and with bullet 120 (25,16%) wounded individuals. The complications of plaural tube inserting were - empyema in 34 (7,13%) patients and there were no other complications. Chest tube inserting as definitive mesaure was used in 398 (83,44%) patients. Chest tube inserting as preoperative measure (urgent thoracotomy) was used in 79 (16,56%) patients. There were 460 (96,44%) healed patients. Death occurred in 17 (3,56%) patients.
Highlights
Chest injuries represent a very complex patho-physiological and therapeutic problem
The total number of patients were treated for penetrating chest injuries in Department of Thoracic Surgery Clinical Centre University of Sarajevo between April - June
Pleural drainage represents the initial choice of treatment in managing the penetrating chest injuries
Summary
Chest injuries represent a very complex patho-physiological and therapeutic problem. Hamilton Bailey in one occasion in said: “A great number of surgeons feel unfortunate when they have to face the problem of urgent chest condition, they find pathophysiological events in urgent chest condition unclear, physical signs hard and complicated for interpretation, and the chest X-ray in many cases misterious”.
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