Caputo Giorgia, Meda Stefano, Piccioni Andrea, Saviano Angela, Ojetti Veronica, Savioli Gabriele, Piccini Gaia Bavestrello, Ferrari Chiara, Voza Antonio, Pellegrini Lavinia, Ottaviani Miriam, Spadazzi Federica, Volonnino Gianpietro, La Russa Raffaele
Division of Anesthesia and Critical Care, Santi Antonio e Biagio e Cesare Arrigo Hospital, 15121 Alessandria, Italy.
Division of Thoracic Surgery, Santi Antonio e Biagio e Cesare Arrigo Hospital, 15121 Alessandria, Italy.
Clin Pract. 2024 Sep 10;14(5):1869-1885. doi: 10.3390/clinpract14050148.
Chest trauma is the leading cause of death in people under 40. It is estimated to cause around 140,000 deaths each year. The key aims are to reduce mortality and the impact of associated complications to expedite recovery and to restore patient's conditions. The recognition of lesions through appropriate imaging and early treatment already in the emergency department are fundamental. The majority can be managed in a non-surgical way, but especially after traumatic cardiac arrest, a surgical approach is required. One of the most important surgical procedures is the Emergency Department Thoracotomy (EDT). The aim of this review is to provide a comprehensive synthesis about the management of thoracic trauma, the surgical procedures, accepted indications, and technical details adopted during the most important surgical procedures for different thoracic trauma injuries. Literature from 1990 to 2023 was retrieved from multiple databases and reviewed. It is also important to emphasize the medico-legal implications of this type of trauma, both from the point of view of collaboration with the judicial authority and in the prevention of any litigation.
胸部创伤是40岁以下人群的主要死因。据估计,每年约有14万人因此死亡。关键目标是降低死亡率以及相关并发症的影响,以加速康复并恢复患者状况。通过适当的影像学检查识别损伤并在急诊科尽早治疗至关重要。大多数情况可通过非手术方式处理,但特别是在创伤性心脏骤停后,需要采取手术方法。最重要的外科手术之一是急诊室开胸手术(EDT)。本综述的目的是全面综合阐述胸部创伤的管理、外科手术、公认的适应症以及针对不同胸部创伤损伤在最重要外科手术过程中采用的技术细节。从多个数据库检索并回顾了1990年至2023年的文献。强调这类创伤在医学法律方面的影响也很重要,这既涉及与司法当局的合作,也关乎预防任何诉讼。