Emergency War Surgery NATO Handbook: Part IV: Regional Wounds and Injuries: Chapter XXVIII: Wounds and Injuries of the Chest

Introduction

United States Department of Defense

About 15% of combat injuries sustained during conventional land warfare will involve the thoracic viscera and/or the chest wall. In two-thirds, the thoracic wound will be the principle injury. The spectrum of injury ranges from casualties with grossly mutilating blast injuries to those with only tiny superficial fragment wounds. The great majority of chest casualties will have penetrating trauma. After excluding the approximately 10% with only soft tissue wounds, the remainder can be categorized into two populations: about two-thirds will have missile wounds of the heart, great vessels, or pulmonary hilum; and the others will have missile wounds of the pulmonary parenchyma. It is unusual for casualties in the former category to present as treatment problems, since the vast majority exsanguinate before reaching a medical treatment facility. By way of contrast, casualties with wounds of the lung usually survive to reach medical treatment, which in most instances involves no more than the insertion of a chest tube. About 5% of the total thoracic casualty population will have sustained blunt trauma, more often than not occurring when an armored fighting vehicle is damaged by a mine. Viewed from the historical perspective, the principal function of thoracic surgery in wartime has not been the performance of emergency life-saving surgery, but rather the management of chronic complications such as clotted hemothorax and empyema. Whether better field resuscitation, more rapid evacuation from the battlefield, and the availability of surgeons trained in the management of thoracic trauma will change the role of thoracic surgery is unclear.

Approved for public release; Distribution is unlimited.

The listing of any non-Federal product in this CD is not an endorsement of the product itself, but simply an acknowledgement of the source. 

Operational Medicine 2001

Health Care in Military Settings

This web version is provided by The Brookside Associates Medical Education Division.  It contains original contents from the official US Navy NAVMED P-5139, but has been reformatted for web access and includes advertising and links that were not present in the original version. This web version has not been approved by the Department of the Navy or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the US Department of Defense or the Brookside Associates. The Brookside Associates is a private organization, not affiliated with the United States Department of Defense.

Contact Us  ·  ·  Other Brookside Products