Skip to main content

Thoracic Damage Control

  • Chapter
  • First Online:
Trauma Surgery

Abstract

The successful management of patients sustaining severe or life-threatening thoracic injuries demands a rapid and organized approach to injury identification and operative intervention based on the principles of damage control surgery. Resuscitative thoracotomy remains the procedure of choice for patients who present in extremis or agonal following both blunt and penetrating truncal trauma. A variety of rapid and effective techniques for hemorrhage control and injury management are available to the trauma surgeon and should be used judiciously in the setting of exsanguination or life-threatening injuries to allow for the rapid transport of patients to the operating room for further temporary or definitive repair of injuries. In this chapter, we shall briefly review the key tenets and principles of damage control surgery as they relate to specific thoracic injuries.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 59.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 79.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Committee on Trauma, American College of Surgeons (2008) ATLS: Advanced Trauma Life Support program for doctors, 8th edn. American College of Surgeons, Chicago

    Google Scholar 

  2. Bickell WH, Wall MJ Jr, Pepe PE et al (1994) Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Engl J Med 331:1105–1109

    Article  CAS  PubMed  Google Scholar 

  3. CRASH-2 Collaborators, Roberts I, Shakur H et al (2011) The importance of early treatment with tranexamic acid in bleeding trauma patients: an exploratory analysis of the CRASH-2 randomised controlled trial. Lancet 377:1096–1101

    Google Scholar 

  4. Rozycki GS, Ballard RB, Feliciano DV et al (1998) Surgeon-performed ultrasound for the assessment of truncal injuries: lessons learned from 1540 patients. Ann Surg 228:557–567

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  5. Feliciano DV, Burch JM, Mattox KL et al (1990) Balloon catheter tamponade in cardiovascular wounds. Am J Surg 160:583–587

    Article  CAS  PubMed  Google Scholar 

  6. Macho JR, Markison RE, Schecter WP (1994) Cardiac stapling in the management of penetrating injuries of the heart: rapid control of hemorrhage and decreased risk of personal contamination. J Trauma 34:711–715; discussion 715–716

    Article  Google Scholar 

  7. Demetriades D, Chahwan S, Gomez H et al (1999) Penetrating injuries to the subclavian and axillary vessels. J Am Coll Surg 188:290–295

    Article  CAS  PubMed  Google Scholar 

  8. Johansen K, Bandyk D, Thiele B, Hansen ST Jr (1982) Temporary intraluminal shunts: resolution of a management dilemma in complex vascular injuries. J Trauma 22:395–402

    Article  CAS  PubMed  Google Scholar 

  9. Cothren C, Moore EE, Biffl WL et al (2002) Lung-sparing techniques are associated with improved outcome compared with anatomic resection for severe lung injuries. J Trauma 53:483–487

    Article  PubMed  Google Scholar 

  10. Wall MJ Jr, Hirshberg A, Mattox KL (1994) Pulmonary tractotomy with selective vascular ligation for penetrating injuries to the lung. Am J Surg 168:665–669

    Article  PubMed  Google Scholar 

  11. Asensio JA, Mazzini FN, Gonzalo R et al (2012) Argon beam coagulator: an effective adjunct to stapled pulmonary tractotomy to control hemorrhage in penetrating pulmonary injuries. J Am Coll Surg 214:e9–e12, Epub 2012 Jan 11

    Article  PubMed  Google Scholar 

  12. Wilson A, Wall MJ Jr, Maxson R, Mattox K (2003) The pulmonary hilum twist as a thoracic damage control procedure. Am J Surg 186:49–52

    Article  PubMed  Google Scholar 

  13. Wagner JW, Obeid FN, Karmy-Jones RC et al (1996) Trauma pneumonectomy revisited: the role of simultaneously stapled pneumonectomy. J Trauma 40:590–594

    Article  CAS  PubMed  Google Scholar 

  14. Defore WW Jr, Mattox KL, Hansen HA et al (1977) Surgical management of penetrating injuries of the esophagus. Am J Surg 134:734–738

    Article  PubMed  Google Scholar 

  15. Glatterer MS Jr, Toon RS, Ellestad C et al (1985) Management of blunt and penetrating external esophageal trauma. J Trauma 25:784–792

    Article  PubMed  Google Scholar 

  16. Vargo DJ, Battistella FD (2001) Abbreviated thoracotomy and temporary chest closure: an application of damage control after thoracic trauma. Arch Surg 136:21–24

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Raul Coimbra MD, PhD, FACS .

Editor information

Editors and Affiliations

3.1 Electronic Supplementary Material

Below is the link to the electronic supplementary material.

(ZIP 653 KB)

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag Italia

About this chapter

Cite this chapter

Kim, D.Y., Coimbra, R. (2014). Thoracic Damage Control. In: Di Saverio, S., Tugnoli, G., Catena, F., Ansaloni, L., Naidoo, N. (eds) Trauma Surgery. Springer, Milano. https://doi.org/10.1007/978-88-470-5459-2_3

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-5459-2_3

  • Published:

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-5458-5

  • Online ISBN: 978-88-470-5459-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics