Zentralbl Chir 2017; 142(04): 421-427
DOI: 10.1055/s-0043-116216
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Thoraxtrauma: Diagnostik und Therapie

Management of Thoracic Trauma
Bassam Redwan
Klinik für Thoraxchirurgie, Helios Universitätsklinikum Wuppertal, Universität Witten/Herdecke
,
Christian Biancosino
Klinik für Thoraxchirurgie, Helios Universitätsklinikum Wuppertal, Universität Witten/Herdecke
,
Katina Nikolova
Klinik für Thoraxchirurgie, Helios Universitätsklinikum Wuppertal, Universität Witten/Herdecke
,
Thorsten Greve
Klinik für Thoraxchirurgie, Helios Universitätsklinikum Wuppertal, Universität Witten/Herdecke
,
Servet Bölükbas
Klinik für Thoraxchirurgie, Helios Universitätsklinikum Wuppertal, Universität Witten/Herdecke
› Author Affiliations
Further Information

Publication History

Publication Date:
24 August 2017 (online)

Zusammenfassung

Patienten mit einem Thoraxtrauma können in den meisten Fällen durch die Anlage einer großlumigen Thoraxsaugdrainage und eine adäquate analgetische Therapie erfolgreich therapiert werden. Die initiale Behandlung richtet sich i. d. R. nach Feststellung der vitalen Notwendigkeit durch den Notarzt bzw. den behandelnden Chirurgen in der Notaufnahme. Schwere intrathorakale Verletzungen im Rahmen eines Polytraumas sind selten. Allerdings handelt es sich meist um akut lebensbedrohliche Situationen. Nach der initialen Stabilisierung stellt die Bildgebung eine essenzielle Grundlage der richtigen Versorgung und einer folgenden Operation dar. Die richtige Einschätzung der intrathorakalen Verletzungen sollte nur interdisziplinär in enger Kooperation zwischen der Anästhesie, Unfallchirurgie, Allgemeinchirurgie und Thoraxchirurgie erfolgen. Daher sollten Patienten mit Thoraxtraumata stets in spezialisierten Zentren mit der erforderlichen Fachexpertise behandelt werden. Dies führt zur Senkung der Sterblichkeit und Verkürzung der Langzeitbehandlung der Patienten.

Abstract

Patients with a thoracic trauma are commonly treated by large bore chest tube thoracostomy and appropriate analgesia. The initial treatment is determined by the assessment of the emergency doctor and/or trauma surgeon. Severe intrathoracic lesions in polytrauma patients are rare. However, such injuries may be acutely life-threating. After primary stabilisation of the patients, imaging studies should be performed to assess the extent of the injuries and determine the treatment of choice. Assessment of such injuries should always be performed in a multidisciplinary team of anaesthesiologists, general surgeons, trauma surgeons and thoracic surgeons. For this reason, patients with thoracic traumas should always be treated in specialised centers. This approach reduces overall mortality and shortens the length of hospital stay.

 
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