Abstract
Trauma thoracotomy can be a lifesaving procedure when performed in a timely and precise manner. Indications for an emergency thoracotomy on a pulseless patient are conditional but include a mechanism of penetrating trauma with or without signs of life and blunt trauma with signs of life. Although anterolateral thoracotomy is the utility procedure, in selected instances, alternative incisions may offer better surgical exposure with less morbidity. All of the incisions can be performed rapidly with practice and experience; all have advantages and disadvantages. If injury to thoracic viscera or vessels has occurred, the initial thoracotomy can be extended to allow adequate exposure for subsequent repair. The emergency thoracotomy is highly invasive and not without complications, prompting the introduction of new endovascular techniques in the emergency setting.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Suggested Readings
Front Line Surgery: A Practical Approach, Editors: Martin M. and Beekley, A.
Top Knife: Art and Craft of Trauma Surgery by Hirschberg and Mattox.
ASSET: Advanced Surgical Skills for Exposure in Trauma by American College of Surgeons Committee on Trauma.
Advanced Trauma Operative Management (ATOM): Surgical Strategies for Penetrating Trauma, Editors: Jacobs, L. and Luk, S.
References
Brohi K. trauma.org. 2006. Retrieved from http://www.trauma.org/index.php/main/article/361/.
Brohi K. trauma.org. 2001. Retrieved from http://www.trauma.org/archive/thoracic/EDTrationale.html.
Eastern Association for the Surgery of Trauma. An evidence-based approach to patient selection for emergency department thoracotomy: a practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2015;79(1):159–73.
Hammada S, et al. Integrating eFAST in the initial management of stable trauma patients: the end of plain film radiography. Ann Intensive Care. 2016;6:62.
Brohi K. trauma.org. 2001. Retrieved from http://www.trauma.org/archive/thoracic/EDTindications.html.
Feliciano D. Thoracotomy in the emergency department. (A. C. Trauma, Producer). 2004. Retrieved from https://www.facs.org/~/media/files/quality%20programs/trauma/publications/thoracotomy.ashx.
Cothren C, Moore E. Emergency department thoracotomy for the critically injured patient: objectives, indications, and outcomes. World J Emerg Surg. 2006;1:4.
Connery C, et al. Paraparesis following emergency room thoracotomy: case report. J Trauma. 1990;30:362.
Brohi K. trauma.org. 2001. Retrieved from http://www.trauma.org/archive/thoracic/EDToperative.html.
Dizon V, et al. Trauma reports. 2003. Retrieved from https://www.ahcmedia.com/articles/25786-ed-thoracotomy-revisited-a-complete-reassessment-of-its-past-present-and-future.
Baker J, et al. Unsuspected human immunodeficiency virus in critically ill emergency patients. JAMA. 1987;257:2609.
Sloan EP, et al. Human immunodeficiency virus and hepatitis B virus seroprevalence in an urban trauma population. J Trauma. 1995;38:736.
Caplan E, et al. Seroprevalence of human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and rapid plasma reagin in a trauma population. J Trauma. 1995;39:533.
Moore L, et al. Resuscitative endovascular balloon occlusion of the aorta for control of noncompressible truncal hemorrhage in the abdomen and pelvis. Am J Surg. 2016;212:1222–30.
Brenner M. A clinical series of resuscitative endovascular balloon occlusion of the aorta for hemorrhage control and resuscitation. J Trauma Acute Care Surg. 2013;75:506–11.
Barnard E, et al. Resuscitative endovascular balloon occlusion of the aorta (REBOA): a population based gap analysis of trauma patients in England and Wales. Emerg Med J. 2015;32(12):926.
Morrison J, et al. A systematic review of the use of resuscitative endovascular balloon occlusion of the aorta in the management of hemorrhagic shock. J Trauma Acute Care Surg. 2016;80:324–34.
Joseph B, et al. Identifying potential utility of resuscitative endovascular balloon occlusion of the aorta: an autopsy study. J Trauma Acute Care Surg. 2016;81:128–32.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Koganti, D., Beekley, A.C. (2018). Fundamentals of Exploratory Thoracotomy for Trauma. In: Palazzo, F. (eds) Fundamentals of General Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-75656-1_21
Download citation
DOI: https://doi.org/10.1007/978-3-319-75656-1_21
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-75655-4
Online ISBN: 978-3-319-75656-1
eBook Packages: MedicineMedicine (R0)