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Lung Injury: Techniques

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Abstract

Thoracic trauma is a common occurrence and may be caused by either penetrating or blunt injury. A majority of patients with chest trauma sustain either a pneumothorax or hemothorax, and most of these injuries can be managed nonoperatively with either observation or a chest tube. Surgical intervention may still be indicated and may require a lung repair or resection. In general, blunt injuries have a lower incidence of operative requirements compared to penetrating injury; however, critical blunt thoracic injury often causes more severe and diffuse lung damage. Thus, patients who require thoracotomy following blunt trauma often require more extensive resections and are associated with higher mortality.

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References

  1. Huh J, Wall MW Jr, Estrera AL, Soltero ER, Mattox KL. Surgical management of traumatic pulmonary injury. Am J Surg. 2003;186:620–4.

    Article  Google Scholar 

  2. Meredith JW, Hoth JJ. Thoracic trauma: when and how to intervene. Surg Clin North Am. 2007;87:95–118.

    Article  Google Scholar 

  3. Stewart KC, Urschel JD, Nakai SS, Gelfand ET, Hamilton SM. Pulmonary resection for lung trauma. Ann Thorac Surg. 1997;63:1587–8.

    Article  CAS  Google Scholar 

  4. Martin MJ, McDonald JM, Mullenix PS, Steele SR, Demetriades D. Operative management and outcomes of traumatic lung resection. J Am Coll Surg. 2006;203:336–44.

    Article  Google Scholar 

  5. Karmy-Jones R, Jurkovich GJ, Nathens AB, Shatz DV, Brundage S, Wall MJ Jr, et al. Timing of urgent thoracotomy for hemorrhage after trauma. Arch Surg. 2001;136:513–8.

    Article  CAS  Google Scholar 

  6. Demetriades D, Velmahos GC. Penetrating injuries of the chest: indications for operation. Scand J Surg. 2002;91:41–5.

    Article  CAS  Google Scholar 

  7. DuBose J, O’Connor JV, Scalea TM. Lung, trachea and esophagus. In: Mattox KL, Moore EE, Feliciano DV, editors. Trauma. 7th ed. New York: McGraw Hill; 2013. p. 468–84.

    Google Scholar 

  8. Petrone P, Asensio JA. Surgical management of penetrating pulmonary injuries. Scand J Trauma Resusc Emerg Med. 2009;17:8.

    Article  Google Scholar 

  9. Cothren C, Moore EE, Biffl WL, Franciose RJ, Offner PJ, Burch JM. Lung-sparing techniques are associated with improved outcome compared with anatomic resection for severe lung injuries. J Trauma. 2002;53:483–7.

    Article  Google Scholar 

  10. Karmy-Jones R, Jurkovich GJ, Shatz DV, Brundage S, Wall MJ, Engelhardt S, et al. Management of traumatic lung injury: a western trauma association multicenter review. J Trauma. 2001;51:1049–53.

    CAS  PubMed  Google Scholar 

  11. Gasparri M, Karmy-Jones R, Kralovich KA, Patton JH Jr, Arbabi S. Pulmonary tractotomy versus lung resection: viable options in penetrating lung injury. J Trauma. 2001;51:1092–7.

    CAS  PubMed  Google Scholar 

  12. Asensio JA, Demetriades D, Berne JD, Velmahos G, Cornwell EE, Murray J, et al. Stapled pulmonary tractotomy: a rapid way to control hemorrhage in penetrating pulmonary injuries. J Am Coll Surg. 1997;185:486–7.

    Article  CAS  Google Scholar 

  13. Velmahos GC, Baker C, Demetriades D, Goodman J, Murray JA, Asensio JA. Lung-sparing surgery after penetrating trauma using tractotomy, partial lobectomy, and pneumonorrhaphy. Arch Surg. 1999;134:186–9.

    Article  CAS  Google Scholar 

  14. Livingston DH, Hauser CJ. Chest wall and lung. In: Feliciano DV, Mattox KL, Moore EE, editors. Trauma. 6th ed. New York: McGraw Hill; 2008. p. 525–52.

    Google Scholar 

  15. Wall MJ Jr, Villavicencio RT, Miller CC, Aucar JA, Granchi TA, Liscum KR, et al. Pulmonary tractotomy as an abbreviated thoracotomy technique. J Trauma. 1998;45:1015–23.

    Article  Google Scholar 

  16. Ferguson MK. Thoracic surgery atlas. Philadelphia, PA: W.B. Saunders; 2007. p. 6–32.

    Google Scholar 

  17. Matsushima K, Aiolfi A, Park C, Rosen D, Strumwasser A, Benjamin E, et al. Surgical outcomes after trauma pneumonectomy: revisited. J Trauma Acute Care Surg. 2018;82:927–32.

    Article  Google Scholar 

  18. Halonen-Watras J, O’Connor J, Scalea T. Traumatic pneumonectomy: a viable option for patients in extremis. Am Surg. 2011;77:493–7.

    Article  Google Scholar 

  19. Vargo DJ, Battistella FD. Abbreviated thoracotomy and temporary chest closure, an application of damage control after thoracic trauma. Arch Surg. 2001;136:21–4.

    Article  CAS  Google Scholar 

  20. O’Connor JV, Dubose J, Scalea TM. Damage-control thoracic surgery: management and outcomes. J Trauma Acute Care Surg. 2014;77:660–5.

    Article  Google Scholar 

  21. Wyrzykowski AD, Feliciano DV. Trauma damage control. In: Feliciano DV, Mattox KL, Moore EE, editors. Trauma. 6th ed. New York: McGraw Hill; 2008. p. 851–69.

    Google Scholar 

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

    Article  Google Scholar 

  23. Phelan HA, Patterson SG, Hassan MO, Gonzalez RP, Rodning CB. Thoracic damage-control operation: principles, techniques, and definitive repair. J Am Coll Surg. 2006;203:933–41.

    Article  Google Scholar 

  24. Wall MJ Jr, Soltero E. Damage control for thoracic injuries. Surg Clin North Am. 1997;77:863–78.

    Article  Google Scholar 

  25. Reul GJ, Mattox KL, Beall AC Jr, Jordan GL Jr. Recent advances in the operative management of massive chest trauma. Ann Thorac Surg. 1973;16:52–63.

    Article  Google Scholar 

  26. Burke SJ, Faber LP. Complications of pulmonary resection. In: Little AG, editor. Complications in cardiothoracic surgery, avoidance and treatment. Elmsford, NY: Blackwell; 2004. p. 67–91.

    Google Scholar 

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Correspondence to Joseph Rabin .

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Rabin, J. (2021). Lung Injury: Techniques. In: Scalea, T.M. (eds) The Shock Trauma Manual of Operative Techniques. Springer, Cham. https://doi.org/10.1007/978-3-030-27596-9_9

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  • DOI: https://doi.org/10.1007/978-3-030-27596-9_9

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-27595-2

  • Online ISBN: 978-3-030-27596-9

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