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[Surgical reconstruction of chest wall instability : Indications, contraindications and timing of surgery]. / Operative Rekonstruktion der Thoraxwandinstabilität : Indikationen, Kontraindikationen und Operationszeitpunkt.
Spering, Christopher; Moerer, Onnen; White, Thomas W; Lehmann, Wolfgang.
Afiliação
  • Spering C; Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie, Universitätsmedizin Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland. christopher.spering@med.uni-goettingen.de.
  • Moerer O; Klinik für Anästhesiologie, Universitätsmedizin Göttingen, Göttingen, Deutschland.
  • White TW; Department of Surgery, Intermountain Medical Center, Murray, UT, USA.
  • Lehmann W; Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie, Universitätsmedizin Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland.
Unfallchirurgie (Heidelb) ; 127(3): 171-179, 2024 Mar.
Article em De | MEDLINE | ID: mdl-38214732
ABSTRACT
The impact of energy on the thorax can lead to serial rib fractures, sternal fractures, the combination of both and to injury of intrathoracic organs depending on the type, localization and intensity. Sometimes this results in chest wall instability with severe impairment of the respiratory mechanics. In the last decade the importance of surgical chest wall reconstruction in cases of chest wall instability has greatly increased. The evidence for a surgical approach has in the meantime been supported by prospective randomized multicenter studies, multiple retrospective data analyses and meta-analyses based on these studies, including a Cochrane review. The assessment of form and severity of the trauma and the degree of impairment of the respiratory mechanism are the basis for a structured decision on an extended conservative or surgical reconstructive strategy as well as the timing, type and extent of the operation. The morbidity (rate of pneumonia, duration of intensive care unit stay and mechanical ventilation) and fatality can be reduced by a timely surgery within 72 h after trauma. In this article the already established and evidence-based algorithms for surgical chest wall reconstruction are discussed in the context of the current evidence.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Parede Torácica / Tórax Fundido Tipo de estudo: Clinical_trials Limite: Humans Idioma: De Revista: Unfallchirurgie (Heidelb) Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Parede Torácica / Tórax Fundido Tipo de estudo: Clinical_trials Limite: Humans Idioma: De Revista: Unfallchirurgie (Heidelb) Ano de publicação: 2024 Tipo de documento: Article