Duhamel P, Bonnet P M, Pons F, Jourdan P, Jancovici R
Service de chirurgie thoracique et générale, hôpital d'instruction des armées Percy, 92, Clamart, France.
Ann Chir Plast Esthet. 2003 Apr;48(2):128-34. doi: 10.1016/s0294-1260(03)00015-3.
The adequate care of thoracic ballistic traumatisms implies a good preliminary knowledge of wounding agents, and of the principles governing lesion-based ballistic, in particular the role played by the meeting with an obstacle which modifies the ballistic behaviour of the projectile, with worsened wounding effects. Authors describe the principal types of involved projectiles and their wound profile applied to the thorax, while stressing the need to treat systematically the wound and not the weapon, and on the importance of the choice of the surgical exploration way of these lesions, which conditions, as from the initial stage, the later choices of the parietal closure and rebuilding methods. The importance of parietal disrepair is therefore an essential decisional factor in the assumption of responsibility and the definition of the therapeutic strategy of these casualties.
对胸部弹道伤的妥善处理意味着要对致伤因素以及基于损伤的弹道学原理有充分的初步了解，特别是与障碍物碰撞所起的作用，这种碰撞会改变射弹的弹道行为并加重致伤效果。作者描述了涉及的主要射弹类型及其应用于胸部的伤口形态，同时强调要系统地处理伤口而非武器，以及选择这些损伤的手术探查方式的重要性，这从初始阶段就决定了后期胸壁闭合和重建方法的选择。因此，胸壁损伤的严重程度是承担责任和确定这些伤员治疗策略的关键决策因素。
