Hori Shinichiro, Miyahara Naofumi, Hiratsuka Masafumi
Department of Thoracic and Cardiovascular Surgery, Saga University, Saga, Japan.
Kyobu Geka. 2022 Aug;75(8):602-605.
A 57-year-old man presented to our hospital with multiple rib fractures and pleural effusion caused by a traffic accident. We inserted a chest tube and diagnosed him with hemothorax. We performed damage control surgery with right thoracotomy in the emergency room to confirm the bleeding point. The main sources of bleeding were multiple rib fractures and lung injury. We performed partial lung resection and gauze packing into the thoracic cavity and confirmed the stability of the patient's hemodynamics. The next day, we performed a second-look operation at which we fixed the rib fractures and confirmed hemostasis. When fixing the ribs, we used a bioabsorbable plate instead of a metal plate. It has been reported that bioabsorbable plates are less susceptible to infection than metal plates. After the operation, the patient's respiratory condition stabilized, and no signs of infection were noted. In our experience, rib fixation using absorbent plates is useful in surgery that requires attention to infection.
一名57岁男性因交通事故导致多处肋骨骨折和胸腔积液入住我院。我们插入了胸管,诊断为血胸。我们在急诊室进行了右胸开胸的损伤控制手术以确定出血点。出血的主要来源是多处肋骨骨折和肺损伤。我们进行了部分肺切除并在胸腔内填塞纱布,确认了患者血流动力学的稳定性。第二天,我们进行了二次手术,固定了肋骨骨折并确认止血。固定肋骨时,我们使用了生物可吸收板而非金属板。据报道,生物可吸收板比金属板更不易感染。术后,患者的呼吸状况稳定,未发现感染迹象。根据我们的经验,在需要关注感染的手术中,使用可吸收板进行肋骨固定是有用的。