Incisions and Approaches for Thoracic Trauma

Although surgical intervention is necessary for only a minority of patients with trauma to the thorax, this subset of patients frequently have life-threatening injuries. The daunting task for the surgeon is to rapidly identify thoracic injuries requiring surgical intervention and decide upon the most appropriate incision for exposure of all injured structures. The formation of well-developed and properly trained emergency medical services (EMS) has led to the rapid transport of trauma victims from the scene to regional trauma centers. As a result, patients that may have historically exsanguinated at the scene are now arriving to the emergency department with weak, but detectable, vital signs. Salvage of such a patient depends upon expeditious control of active hemorrhage via an appropriate surgical exposure. Due to the historical infrequency of these severe thoracic injuries, however, most surgeons lack sufficient experience to properly address the involved challenges.