Zusammenfassung
Häufig sind thorakale Verletzungen Begleitverletzungen im Rahmen eines Polytraumas.
Die Therapie polytraumatisierter Patienten ist anspruchsvoll und nur im interdisziplinären
Kontext erfolgversprechend. Aus thoraxchirurgischer Sicht steht dabei das stumpfe
Thoraxtrauma im Vordergrund.
Abstract
The therapy of severely injured patients is demanding and promising only in an interdisciplinary
context. From a thoracic surgical perspective, the blunt chest trauma is in the foreground;
as it is the 2nd leading cause of death after traumatic brain injury. The first step
is to identify the potentially life-threatening injury and its treatment (airway obstruction,
prevention of gas exchange, tension pneumothorax, serious bleeding complications in
lung-/vascular injuries). Pneumothorax or tension pneumothorax is present in 20% of
all polytrauma patients and 50% of all patients with severe chest trauma. In most
cases, the use of a chest tube is sufficient in the acute phase (90%). For complex
injuries with persistent thoracic haemorrhage and haemodynamic instability of the
patient or pleural fistulization with increasing skin emphysema, surgical treatment
should be performed at an early interval. Nevertheless, emergency thoracotomy is rarely
required at this early
stage.
Schlüsselwörter
Polytrauma - Thoraxdrainage - Pneumothorax
Key words
severely injured patient - chest tube - pneumothorax