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闪光震撼弹爆炸导致的创伤性胸部爆震伤伴广泛软组织损伤、肌肉体积缺失和全层烧伤:一例报告

Traumatic Thoracic Blast Injury With Extensive Soft Tissue Damage, Volumetric Muscle Loss, and Full-Thickness Burns From a Flashbang Detonation: A Case Report.

作者信息

Patel Sahil, Echeverri Roberto

机构信息

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.

出版信息

Cureus. 2024 Dec 1;16(12):e74920. doi: 10.7759/cureus.74920. eCollection 2024 Dec.

DOI:10.7759/cureus.74920
PMID:39624812
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11608635/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9857/11608635/617c28c183e7/cureus-0016-00000074920-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9857/11608635/6a8c644a2445/cureus-0016-00000074920-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9857/11608635/617c28c183e7/cureus-0016-00000074920-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9857/11608635/6a8c644a2445/cureus-0016-00000074920-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9857/11608635/617c28c183e7/cureus-0016-00000074920-i02.jpg

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本文引用的文献

1
Penetrating Chest trauma with right atrium rupture - A case report.穿透性胸部创伤伴右心房破裂——一例报告
Trauma Case Rep. 2023 Jan 7;43:100758. doi: 10.1016/j.tcr.2023.100758. eCollection 2023 Feb.
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Materials and techniques in chest wall reconstruction: a review.胸壁重建的材料与技术:综述
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3
Lessons from a large trauma center: impact of blunt chest trauma in polytrauma patients-still a relevant problem?大型创伤中心的经验教训:钝性胸部创伤对多发伤患者的影响——仍然是一个相关问题?
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Return to Function, Complication, and Reoperation Rates Following Primary Pectoralis Major Tendon Repair in Military Service Members.军人原发性胸大肌腱修复后的功能恢复、并发症及再次手术率
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Chest wall reconstruction after extended resection.扩大切除术后胸壁重建。
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Workhorse flaps in chest wall reconstruction: the pectoralis major, latissimus dorsi, and rectus abdominis flaps.工作马在胸壁重建中的应用:胸大肌、背阔肌和腹直肌皮瓣。
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