ABSTRACT
Surgical stabilization of the flail chest is challenging and has no established guidelines. Chest wall integrity and stability are the main factors that ensure the protection of intrathoracic organs and an adequate respiratory function. Here, we report a novel chest wall reconstruction technique in a 45-year-old man with a traumatic left flail chest and open pneumothorax diagnosed both clinically and radiographically. Rib approximation and chest wall reconstruction was done using intercostal figure-of-eight suture and polypropylene mesh with vascularized musculofascial flap. The patient improved gradually and was discharged after three weeks of total hospital stay. He returned to regular working after a month with no evidence of respiratory distress or paradoxical chest movement. Follow-up visit at one year revealed no lung hernia or paradoxical chest movement. This is a novel, feasible and cost-effective modification of chest wall reconstruction that can be adopted for thoracic wall repair in case of open flail chest, which needs emergency surgical interventions even in resource constraint settings.
Subject(s)
Humans , Male , Middle Aged , Flail Chest/surgery , Polypropylenes , Surgical Mesh , Sutures , Thoracic Wall/surgeryABSTRACT
Introduction: Chest trauma both blunt and penetratingconstitutes 10-15% of all traumas and 25% of all deaths fromtraumatic injuries.Case report: We present a case of penetrating right chesttrauma following road traffic accident (RTA) with big metallicrod in-situ, entering from right axillary region and coming outfrom posterior chest wall. The force of impact was so severethat the heavy iron rod got bent upon itself making its removala surgical challenge.Conclusion: In cases of penetrating chest trauma earlyassessment, accurate diagnosis, and rapid transport with noattempt to remove the penetrating foreign body and meticulousplanning play key role in its successful management.