Patel Sahil, Echeverri Roberto
Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA.
Department of Family Medicine, Miami Veterans Affairs Medical Center, Miami, USA.
Cureus. 2024 Dec 1;16(12):e74920. doi: 10.7759/cureus.74920. eCollection 2024 Dec.
Chest trauma is a common injury in civilian and military polytrauma patients and is a leading cause of death and chronic disabilities. Evolving surgical techniques and advancements in chest wall reconstruction have improved clinical outcomes, reduced operative complications, and decreased mortality. In this case report, a 23-year-old male U.S. Army soldier sustained a left chest wall and shoulder blast injury with significant soft tissue damage, volumetric pectoralis major muscle loss, mild sensory nerve damage, and third-degree burns from a flashbang grenade. The initial treatment involved wound debridement, IV antibiotics, and pain management. This was followed by surgical reconstruction using a local advancement flap to prevent infection, address tissue loss, and restore chest wall integrity. Postoperative care included pain management and physical therapy, leading to a successful recovery with restored mobility and chest wall stability. This case highlights the challenges of treating severe chest wall trauma with burns, emphasizing the importance of timely surgical intervention and a multidisciplinary approach.
胸部创伤在 civilian 和 military 多发伤患者中是一种常见损伤,并且是死亡和慢性残疾的主要原因。不断发展的外科技术和胸壁重建方面的进步改善了临床结果,减少了手术并发症,并降低了死亡率。在本病例报告中,一名23岁的美国陆军男性士兵遭受了左胸壁和肩部爆炸伤,伴有严重的软组织损伤、胸大肌大面积缺失、轻度感觉神经损伤以及来自闪光震撼弹的三度烧伤。初始治疗包括伤口清创、静脉注射抗生素和疼痛管理。随后采用局部推进皮瓣进行手术重建,以预防感染、解决组织缺损并恢复胸壁完整性。术后护理包括疼痛管理和物理治疗,最终成功康复,恢复了活动能力和胸壁稳定性。本病例突出了治疗伴有烧伤的严重胸壁创伤的挑战,强调了及时手术干预和多学科方法的重要性。