Chapter 48 - Penetrating Thoracic Trauma

Question 1

Penetrating thoracic trauma (PTT) vs perforating trauma?

Answer 1

Penetrating thoracic trauma (PTT) is defined as any wound that extends from the outside of the thoracic wall through the pleural lining.
Perforating trauma is where the injury passes completely through the body cavity

Question 2

For patients presenting with an impalement injury, it is essential to remove the object first. True or False?

Answer 2

For patients presenting with an impalement injury, it is essential not to remove the object. The patient should be stabilized, appropriate diagnostic testing performed and the object removed as part of a planned surgical procedure.

Question 3

Common types of penetrating injuries in veterinary medicine?

Answer 3

The most common type of penetrating injuries in veterinary medicine are bite wounds from other animals. Other documented causes of PTT include gunshot wounds (GSW), impalement injuries

Question 4

The number of thoracic radiographic lesions are significantly associated with mortality. True vs False?

Answer 4

Thoracic radiographs underestimate the amount of intercostal damage and thoracic wall defects when compared to surgical exploration of wounds

Question 5

Using antibiotics in penetrating thoracic trauma patients?

Answer 5

ALL PTT wounds are potentially contaminated with the resident skin flora of the patient or soil organisms.
All PTT patients should be administered broad-spectrum antibiotics at the time of presentation.

A deep tissue culture and susceptibility testing should be submitted following clipping and lavage of the wounds or following surgical exploration to allow for tailored antibiotic therapy once results are available.