Emergency thoracic surgery for penetrating, non-mediastinal trauma.
BACKGROUND
Penetrating thoracic injury is commonly found in South Africa. A review of our recent experience was undertaken to assess the effectiveness of our protocols for this type of injury.


METHODS
A retrospective study of 61 consecutive patients with penetrating, non-mediastinal trauma to the chest was conducted over 32 months at a single trauma unit. Patient details, mechanism of injury, operative procedure and in-hospital mortality and morbidity rates were recorded.


RESULTS
Two thousand and nineteen patients presented with penetrating chest injury of which 61 patients (3%) underwent thoracic surgery for non-mediastinal injury. Twenty-six patients had stab wounds and 35 had gunshot wounds. Overall mortality was 17/61 (28%). Gunshot wounds were more likely to result in death than stab wounds (relative risk = 11.9; 95% confidence interval 1.7-84.0) and thoracoabdominal injury resulted in death more commonly than chest injury (relative risk = 4.8; 95% confidence interval 2.2-10.3) resulted in death.


CONCLUSIONS
Penetrating chest injury is common and most patients can be managed without formal thoracic surgical intervention. However, the patients who do merit surgical intervention have a relatively high mortality and a rapid and practised operative approach is required to achieve acceptable results.
Loogna
Peter
P
Department of Surgery, Chris Hani Baragwanath Hospital, University of Witwatersrand, Johannesburg, South Africa.
Bonanno
Fabrizio
F
Bowley
Douglas M
DM
Doll
Dietrich
D
Girgensohn
Roland
R
Smith
Martin D
MD
Glapa
Miriam
M
Degiannis
Elias
E
D000293:Adolescent; D000328:Adult; D002985:Clinical Protocols; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013019:South Africa; D013898:Thoracic Injuries / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome; D014950:Wounds, Penetrating / Q000401:mortality / Q000601:surgery*