SURGICAL TACTICS IN PATIENTS WITH PENETRATING THORACIC INJURIES

Keywords: penetrating thoracic wounds, videothoracoscopic interventions, thoracotomy

Abstract

To date, the basis of surgical tactics for chest injuries is the primary surgical treatment of the wound and drainage of the pleural cavity with dynamic monitoring and determination of indications for surgery, based on the amount of blood released by drainage, without any attempts to actively verify the nature of injuries.
Treatment of patients on the basis of the so-called "individual approach" and active-waiting tactics, taking into account clinical, radiological and laboratory data, mainly meets the recommendations of the middle of the last century.
From the standpoint of evidence-based medicine, thoracoscopy is the most effective method of topical diagnosis of traumatic hemothorax. Videothoracoscopic technologies significantly reduce the incidence of purulent intrapulmonary and pleural complications in penetrating lung injuries. Undoubted advantages of thoracoscopy are: full-fledged revision; accurate diagnosis, which eliminates doubts about the diagnosis and waiting period; determination of indications for drainage, operative thoracoscopy or thoracotomy.

References

Ramachandran A et al (2017), Comparison of epidemiology of the injuries and outcomes in two first-level trauma centers in colombia using the pan-american trauma registry system, “World Journal of Surgery”, 1–7.

Ruelas O.S., Tschautscher C.F., Lohse C.M. and So (2018), Analysis of prehospital scene times and interventions on mortality outcomes in a national cohort of penetrating and blunt trauma patients, “Prehospital Emerg Care”, 22, 691-697.

Kim, M., and Moore, J.E. (2020), Chest Trauma: Current Recommendations for Rib Fractures, Pneumothorax, and Other Injuries, “Curr Anesthesiol Rep”, 10, 61–68.

Battle CE, Hutchings H, and So (2012), Risk factors that predict mortality in patients with blunt chest wall trauma: a systematic review and meta-analysis, “Injury”, 43(1), 8–17.

Khomenko, I., Gerzhyk, K., and So (2018), The place and role of videothoracoscopic surgical interventions in war wounds and injuries of the chest organs, “Reports of Vinnytsia National Medical University”, 22(3), 522-524.

Boyko, V. V et al. (2020), Determination of therapeutic and diagnostic tactics in penetrating shooting and punch-cutting injuries of the chest using spiral computer tomography, “Kharkiv Surgical School”, 4, 47-54.

Huis MA, Craft SA, and So (2018), Blunt Cardiac Trauma Review, “Cardiol Clin.”, 2, 183-191.

Kruit N et al. (2019), Assessment of safety and bleeding risk in the use of ECMO for multi-trauma patients: a multicentre review, “J Trauma Acute Care Surg.”, 86, 967–973.

McDonald Johnston, A. and Alderman, J.E. (2020), Thoracic Injury in Patients Injured by Explosions on the Battlefield and in Terrorist Incidents, “Chest”, 157, 888–897.

Avaro J-P, De Lesquen H, and So (2017), Specific elements of thoracic wound management, “J Visc Surg.”, 1, 31-33.

R.M. Afzal, et al. (2018), Thoracic impalement injury: a survivor with large metallic object in-situ, “Chin. J. Traumatol.”, 21, 369-372.

Y.W. Liu et al. (2018), Survival of the fittest: the role of video-assisted thoracoscopic surgery in thoracic impalement injuries, “J. Thorac. Dis.”, 10 (7), 4445-4452.

Views:

141

Downloads:

197

Published
2021-04-09
Citations
How to Cite
Belozоrov Igor, Kudrevych Oleksandr, Kosov Eugene, Rozhkova Olena, Barsukov Nikita, & Veklych Viktor. (2021). SURGICAL TACTICS IN PATIENTS WITH PENETRATING THORACIC INJURIES. World Science, (4(65). https://doi.org/10.31435/rsglobal_ws/30042021/7537
Section
Medicine