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Fundamentals of Exploratory Thoracotomy for Trauma

  • Deepika Koganti
  • Alec C. Beekley
Chapter

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.

Keywords

Emergency thoracotomy Sternotomy Aortic cross clamp Pericardiotomy Thoracic trauma Cardiac tamponade 

Suggested Readings

  1. Front Line Surgery: A Practical Approach, Editors: Martin M. and Beekley, A.Google Scholar
  2. Top Knife: Art and Craft of Trauma Surgery by Hirschberg and Mattox.Google Scholar
  3. ASSET: Advanced Surgical Skills for Exposure in Trauma by American College of Surgeons Committee on Trauma.Google Scholar
  4. Advanced Trauma Operative Management (ATOM): Surgical Strategies for Penetrating Trauma, Editors: Jacobs, L. and Luk, S.Google Scholar

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of SurgerySidney Kimmel Medical College, Thomas Jefferson UniversityPhiladelphiaUSA
  2. 2.Department of Surgery, Division of Acute Care Surgery, Division of Bariatric SurgerySidney Kimmel Medical College at Thomas Jefferson UniversityPhiladelphiaUSA

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