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Erschienen in: European Journal of Trauma and Emergency Surgery 4/2015

01.08.2015 | Original Article

Open pneumothorax: the spectrum and outcome of management based on Advanced Trauma Life Support recommendations

verfasst von: V. Y. Kong, M. Liu, B. Sartorius, D. L. Clarke

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 4/2015

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Abstract

Introduction

The current management of open pneumothorax (OPTX) is based on Advanced Trauma Life Support (ATLS) recommendations and consists of the application of a three-way occlusive dressing, followed by intercostal chest drain insertion. Very little is known regarding the spectrum and outcome of this approach, especially in the civilian setting.

Materials and methods

We conducted a retrospective review of 58 consecutive patients with OPTX over a four-year period managed in a high volume metropolitan trauma service in South Africa.

Results

Of the 58 patients included, 95 % (55/58) were male, and the mean age for all patients was 21 years. Ninety-seven percent of all injuries were inflicted by knives and the remaining 3 % (2/58) of injuries were inflicted by unknown weapons. 59 % of injuries were left sided. In six patients (10 %) a protocol violation was present in their management. Five of the six patients (83 %) in whom protocol violation occurred developed a life-threatening event (tension PTX) compared to none amongst those where the protocol was followed (p < 0.001). There was no mortality as a direct result of management of OPTX following ATLS recommendations.

Conclusions

ATLS recommendations for OPTX are safe and effective. Any deviation from this standard practice is associated with avoidable morbidity and potential mortality.
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Metadaten
Titel
Open pneumothorax: the spectrum and outcome of management based on Advanced Trauma Life Support recommendations
verfasst von
V. Y. Kong
M. Liu
B. Sartorius
D. L. Clarke
Publikationsdatum
01.08.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Trauma and Emergency Surgery / Ausgabe 4/2015
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-014-0469-5

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