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A thoracostomy is a small incision of the chest wall, [1] with maintenance of the opening for drainage. [2] It is most commonly used for the treatment of a pneumothorax.This is performed by physicians, paramedics, and nurses usually via needle thoracostomy or an incision into the chest wall with the insertion of a thoracostomy tube (chest tube) or with a hemostat and the provider's finger ...
The injury may also affect a specific organ such as the heart, which can develop an air embolism or a cardiac tamponade (which prevents the heart from beating properly). The primary indication for a resuscitative thoracotomy is a patient with penetrating chest trauma who has entered or is about to enter cardiac arrest. [4]
The Nuss procedure is a minimally invasive procedure, invented in 1987 by Dr. Donald Nuss and his colleagues, Dr. Daniel Croitoru and Dr. Robert Kelly, for treating pectus excavatum. [ 1 ] [ 2 ] [ 3 ] He developed it at Children's Hospital of The King's Daughters , in Norfolk, Virginia .
Pericardiocentesis is a one-off procedure, which may not be appropriate for long-term drainage. In cases where longer term drainage is needed, the cardiothoracic surgeon can create a pericardial window. This involves the removal of a section of the pericardium, and the placement of a chest tube. [citation needed]
Chest tube have an end hole (proximal, toward the patient) and a series of side holes. The number of side holes is generally 6 on most chest tubes. The length of tube that has side holes is the effective drainage length (EDL). In chest tubes designed for pediatric heart surgery, the EDL is shorter, generally by only having 4 side holes. [17]
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In traumatic pneumothorax, chest tubes are usually inserted. If mechanical ventilation is required, the risk of tension pneumothorax is greatly increased and the insertion of a chest tube is mandatory. [13] [40] Any open chest wound should be covered with an airtight seal, as it carries a high risk of leading to tension pneumothorax.
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