Stable Penetrating Chest Trauma

Annotation for Point G

Open chest wounds can lead to immediate ventilatory compromise. Initial management in the emergency department is to occlude the defect and place a chest tube. Depending on the size and degree of tissue damage, management can range from simple debridement and closure to complex, staged coverage using bioprosthetics and muscle/cutaneous flaps. Devastating chest wall injuries, such as those related to close-range shotgun blasts, may be approached in a similar fashion, even if a sucking wound is not present. In complex destructive chest wall injuries, it is important to debride devitalized tissue and remove all foreign material as soon as practical to prevent necrotizing infections.