TRAUMATIC HEMOTHORAX - EXPERIENCE OF A PROTOCOL FOR RAPID TURNOVER IN1845 CASES

Incomplete or prolonged drainage of the pleural cavity for haemothorax may lead to the development of empyema, with long-term morbidity. Usi ng a protocol based on vigorous physiotherapy and early withdrawal of the thoracostomy tube (average drainage time 27,1 hours), hospital sta y in 1 845 patients with traumatic haemothorax was 48 hours or less in 81,8% of patients. In all, 152 haemothorax patients (8,1%) required e ither early or late thoracotomy, 46 of which were for associated cardi ac injury. Prophylactic antibiotics were not given routinely. Severe c omplications occurred in 40 patients (2,2%); 15 developed empyema (0,8 %) and 25 died (1,4%), mainly from ongoing haemorrhage. The early iden tification of patients needing operative or other intervention minimis es the hospital stay and complications associated with residual blood in the pleural cavity. This study shows that the short-period drainage protocol used gives very acceptable results in the treatment of traum atic haemothorax.