title: Selective packing for uncontrollable traumatic thoracic wall bleeding preserving cardiopulmonary function.
abstract: BACKGROUND
  Uncontrollable chest wall bleeding secondary to thoracic trauma has been a challenging problem faced by surgeons. Thoracic packing has been described as a good alternative although most thoracic surgeons avoid it because of the potential deleterious effects on cardiopulmonary function.
  
  
  METHODS
  We describe a selective gauze packing technique of the thoracic wall preserving cardiopulmonary function in 3 patients with uncontrollable bleeding, where gauze packs were placed on bleeding areas holding them in a "sandwich-like" arrangement between the skin and the pleura and tightly fixed with coated wire stitches using internal and external-thoracic Ventrofil® devices.
  
  
  RESULTS
  Successful hemostasis and cardio-respiratory stability were achieved in all cases after selective packing. X-ray showed acceptable lung expansion and no heart compression.
  
  
  CONCLUSIONS
  This selective packing technique is simple, feasible and highly effective in managing uncontrollable post-traumatic or even post-operative chest wall hemorrhages when the life of patients is in danger.
authors.affiliation: Department of Thoracic Surgery, Hospital Universitario Insular, Las Palmas de Gran Canaria, Canary Islands, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Pérez-Alonso
authors.affiliation: Department of Thoracic Surgery, Mount Sinai Health System, New York, USA; Instituto Universitario de Investigaciones Biomédicas y Sanitarias (IUIBS)-BioPharm Group, Las Palmas de Gran Canaria, Canary Islands, Spain. Electronic address: norbesanrod@gmail.com.
authors.forename: Norberto
authors.initials: N
authors.lastname: Santana-Rodríguez
authors.affiliation: Department of Thoracic Surgery, Hospital Universitario Insular, Las Palmas de Gran Canaria, Canary Islands, Spain.
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Cano
authors.affiliation: Department of Thoracic Surgery, Mount Sinai Health System, New York, USA.
authors.forename: Adil
authors.initials: A
authors.lastname: Ayub
authors.affiliation: Department of Thoracic Surgery, Mount Sinai Health System, New York, USA; Icahn School of Medicine, New York, USA.
authors.forename: Wissam
authors.initials: W
authors.lastname: Raad
authors.affiliation: Department of Thoracic Surgery, Mount Sinai Health System, New York, USA.
authors.forename: Khalid
authors.initials: K
authors.lastname: Alshehri
authors.affiliation: Department of Thoracic Surgery, Mount Sinai Health System, New York, USA.
authors.forename: César
authors.initials: C
authors.lastname: Calderón-Murgas
authors.affiliation: Department of Thoracic Surgery, Hospital Universitario Insular, Las Palmas de Gran Canaria, Canary Islands, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Hernández
authors.affiliation: Department of Thoracic Surgery, Hospital Universitario Insular, Las Palmas de Gran Canaria, Canary Islands, Spain.
authors.forename: Gara
authors.initials: G
authors.lastname: Torrent
authors.affiliation: Department of Thoracic Surgery, Mount Sinai Health System, New York, USA; Icahn School of Medicine, New York, USA.
authors.forename: Faiz Y
authors.initials: FY
authors.lastname: Bhora
mesh_terms: D001458:Bandages; D006321:Heart / Q000502:physiology; D006470:Hemorrhage / Q000209:etiology* / Q000628:therapy*; D006487:Hemostasis; D006489:Hemostatic Techniques; D006801:Humans; D008168:Lung / Q000502:physiology; D012720:Severity of Illness Index; D013898:Thoracic Injuries / Q000150:complications* / Q000601:surgery; D035441:Thoracic Wall / Q000293:injuries*
keywords: Bleeding; Packing; Thoracic wall; Trauma; Uncontrollable