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ORIGINAL ARTICLE
Year : 2020  |  Volume : 10  |  Issue : 4  |  Page : 189-194

Complications following chest tube insertion pre-and post-implementation of guidelines in patients with chest trauma: A retrospective, observational study


1 Department of Trauma Surgery, Hamad General Hospital, Doha, Qatar
2 Department of Surgery, Hamad General Hospital, Doha, Qatar
3 Department of Surgery, Clinical Research, Trauma and Vascular Surgery, Hamad General Hospital; Department of Clinical Medicine, Weill Cornell Medical College, Doha, Qatar

Correspondence Address:
Dr. Ayman El-Menyar
Department of Surgery, Clinical Research, Hamad General Hospital, P.O. Box 3050, Doha
Qatar
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJCIIS.IJCIIS_98_19

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Background: The need to evacuate the chest after a penetrating wound was first recognized in the 18th century. Most thoracic injuries are treated with tube thoracostomy (TT) which refers to the insertion of a TT into the pleural cavity to drain air, blood, pus, or other fluids. However, TT has been challenged in the trauma care due to insertional, positional, or infective complications. Methods: A retrospective study of all trauma patients who had TT insertion from 2008 to 2014 was conducted based on the trauma registry data to describe patient characteristics, injury characteristics, management, and outcomes. The complication incidences per TT before (2008) and after (2009–2014) the implementation of standard protocol were compared. Results: During the study period, 804 patients were managed with 1004 TT procedures. The mean age was 34 years, and majority (91%) was males. Motor vehicle crash (43%) was the main mechanism of injury. Mean injury severity score was 22. The rib fractures (68%) were more frequent followed by pneumothorax (49%). Nearly 72% of patients received antibiotic coverage before insertion. The complications developed per TT reduced over the years from 2008 to 2014 (12.6% to 4.4%). The average complication per TT after the protocol implementation (2009–2014) reduced by 7% when compared to the duration before implementation (2008). Conclusions: The present study shows that standardized management of trauma patients who undergo TT results in a reduction in complications, helps improve patient flow, and ensures the proper management of resources in our high-volume trauma center.


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