Chest trauma management: good outcomes possible in a general surgical unit

ABSTRACT

To determine the predominant pattern of injuries following chest trauma and assess the adequacy of the management strategies employed in a general surgical unit of a trauma care hospital. This Case Series study with prospective data collection was conducted in Surgical Unit-Il ft Unit-VI of Civil Hospital Karachi, from September 2007 to February 2009. One hundred and three consecutive patients with thoracic trauma presenting in emergency department were evaluated. Patients above 12 years of age, who presented with chest trauma either alone or associated with multiple trauma were included. A total of 103 patients were studied for various chest injuries during eighteen months period. As a whole 58% of patients had blunt chest injury as compared to 42% who had penetrating injuries. Thirty patients [29%] had chest wall injuries [rib fracture, mild lung contusion] without haemothorax or pneumothorax, who were managed conservatively. Chest intubation was required in 64 patients [62%] having hemothorax I pneumothorax. Thoracotomy was required in nine patients [9%], in which only two were emergency thoracotomy and seven were elective. Over all mortality rate was 8%.Penetrating injury of chest is rising with time due to gunshot injuries although blunt trauma is still more common. Majority of chest trauma patients can be managed in a general surgical unit satisfactorily and few patients need major operative management