Temporary chest closure and open chest management for severe chest trauma: a retrospective study of 10 cases at a single hospital.

Abstract

<h4>Objectives</h4>Evidence to establish standardized damage control surgery for severe chest trauma is insufficient. Therefore, we aimed to evaluate the outcomes, complications, effectiveness, and safety of temporary chest closure and open chest management in our hospital.<h4>Methods</h4>We retrospectively reviewed the backgrounds and perioperative outcomes of 10 patients who underwent open chest management with temporary chest closure for severe trauma at our hospital from January 2015 to June 2024 using their medical records.<h4>Results</h4>The median patient age was 54 years, nine patients had blunt multiple trauma, and one patient had an isolated, penetrating chest injury. All patients had hemorrhagic shock upon arrival: the median chest Abbreviated Injury Scale score and Injury Severity Score were 4.5 and 30, respectively. The initial chest surgery was thoracotomy-based hemostasis for injuries of the chest wall, lungs, heart, and great vessels in six cases, and pulmonary resection for lung injury in four cases; all cases involved open chest management with temporary chest closure after intrapleural gauze packing. The median operative time and intraoperative bleeding was 72 min and 1710 mL, respectively. Seven of the 10 patients survived, with a median open chest management period of 2 days, with no postoperative empyema or wound infection.<h4>Conclusion</h4>Open chest management with temporary chest closure for severe chest trauma is useful for the prompt completion of the initial chest surgery and initiation of treatment for concomitant injuries and resuscitation in the intensive care unit.