Lesiones penetrantes y transfixiantes en los traumatismos abiertos del tórax

La gravedad y el peligro para la vida que acompanan a las lesiones penetrantes y transfixiantes del torax y la necesidad de una respuesta inmediata con un diagnostico y tratamiento precoz, motivaron a profundizar en el estudio de estos traumatismos, evaluar la aplicacion oportuna del tratamiento quirurgico, determinar los agentes vulnerantes causales, los organos mas afectados y las complicaciones. Se realizo un estudio retrospectivo en 116 pacientes atendidos en el Hospital Militar Central "Dr. Carlos J. Finlay" en un periodo de 4 anos, con traumatismos abiertos del torax; 80 pacientes presentaron lesiones penetrantes o transfixiantes. Se analizo la edad, el sexo, los agentes vulnerantes, las lesiones viscerales, la terapeutica y las complicaciones. Se comprobo que los pacientes del sexo masculino en la tercera decada de vida fueron los mas afectados, y como agentes vulnerantes predominaron los punzocortantes. El pulmon fue el organo intratoracico mas lesionado; el 97 % de los pacientes presentaron neumotorax, hemotorax o hemoneumotorax, asociado con un colapso pulmonar y compromiso respiratorio severo. Se realizo la toracotomia en el 37 % de los pacientes y su indicacion se considero siempre correcta. La sepsis de la herida traumatica fue la complicacion mas frecuente.(AU) The severity and danger for life caused by the penetrating and transfixing chest injuries and the need of an immediate response with an early diagnosis and treatment, motivated us to go deep into the study of these traumas, to evaluate the timely application of the surgical treatment, to determine the causal injuring agents, the most affected organs and the complications. A retrospective study of 116 patients with open traumas of the chest that were attended at "Dr. Carlos J. Finlay" Military Central Hospital during 4 years was conducted. 80 patients had penetrating or transfixing injuries. Age, sex, the injuring agents, the visceral injuries, the therapeutics and the complications were analyzed. It was proved that male patients were the most affected during the third decade of life. It was also observed a predominance of puncturing and cutting agents. The lung was the most injured intrathoracic organ. 97 % of the patients had pneumothorax, hemothorax or hemopneumothorax., associated with a collapse of the lung and severe respiratory compromise. Thoracotomy was performed in 37 % of the patients and its indication was always considered as correct. The sepsis of the traumatic wound was the commonest complication.(AU)