Fundamentals of Exploratory Thoracotomy for Trauma
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.
KeywordsEmergency thoracotomy Sternotomy Aortic cross clamp Pericardiotomy Thoracic trauma Cardiac tamponade
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