Penetrating stab wounds of the chest--when should chest physiotherapy commence? A comparative study.

In an effort to optimise the physiotherapy management of patients with penetrating stab wounds to the chest, 26 male patients, aged between 18 and 30 years, were randomised to one of two groups on admission to Hillbrow Hospital. The patients in group I received chest physiotherapy immediately after insertion of the intercostal drain, while patients in group II received chest physiotherapy 9-12 hours after insertion of the drain as is currently the normal hospital procedure. Mean duration of intercostal drainage in group I was 40 hours and that in group II 65.92 hours. Patients in group I had significantly shorter intercostal drainage times than patients in group II (P = 0.0001). Patients in group I had a mean hospital stay of 43.96 hours while patients in group II had a mean hospital stay of 77.53 hours (P = 0.0001). There was a significant difference in the duration of hospitalisation between the two groups, this being shorter in group I than in group II. The prevalence of spiking temperatures was also significantly lower in group I than in group II, since only 2 patients in group I but 8 patients in group II developed a spiking temperature (P = 0.0207). This study suggests that an aggressive approach of immediate chest physiotherapy in these patients has definite beneficial results.