Penetrating Chest Trauma: Tube Thoracostomy with Application of Low Pressure Continuous Suction, Management and Outcome, the Rate and Identifying the Causes in Iraqi Kurdistan Region, Sulaimanyah City
Keywords:
Penetrating chest trauma, low pressure suction, tube thoracostomyAbstract
Background and Objectives: Penetrating chest trauma is still common in the developing countries as elsewhere. We studied the rate, causes and the outcome in patients with penetrating chest trauma who managed by tube thoracostomy with application of continuous low pressure suction. The aims of the study were to see the rate of penetrating chest injuries in sulaimanyah city, identifying its causes and to evaluate the effectiveness of tube thoracostomy and applying continuous low pressure suction.
Methods: This study was conducted in the department of thoracic and cardiovascular surgery, sulaimani teaching hospital, sulaimanyah city from July 2007 to October 2009. This study included 48 patients. 40/48 patients were male and 8/48 female. The average age was 27.2 years (range, 16-50). They sustained a penetrating chest trauma from firearm (gunshots) or stabbing wound. They underwent tube thoracostomy and continuous low pressure suction applied to their chest drains.
Results: In our study 21/48 patients were injured by stabbing by knife, 19/48 were injured by gunshots, 5/48 by shell (mines, explosion) and 3/48 by sharp objects.Full lung expansion was achieved in forty (83%) patients. Partial lung expansion or pneumothorax was present in eight (17%) patients. Three patients (6%) developed complications.
Conclusions Our study showed that stab wounds and gunshots constitute the main cause of penetrating chest trauma in our area. Placing chest tubes on continuous low pressure suction helps evacuation of blood, expansion of lung and prevents the development of clotted haemothorax. It also reduces the time to removal of chest drains and the hospital stay.
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