Schachner T, Isser M, Haselbacher M, Schröcker P, Winkler M, Augustin F, Lederer W. Rescue blanket as a provisional seal for penetrating chest wounds in a new ex vivo porcine model.
Ann Thorac Surg 2021;
114:280-285. [PMID:
34370985 DOI:
10.1016/j.athoracsur.2021.06.083]
[Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 06/10/2021] [Accepted: 06/25/2021] [Indexed: 11/01/2022]
Abstract
BACKGROUND
Open pneumothorax after a penetrating thorax trauma is a life-threatening disease with high mortality. Emergency application of a chest seal allowing the release of trapped air is the optimum initial therapy until surgical chest drainage is available.
METHODS
In a newly developed experimental porcine model of open pneumothorax we tested three different materials regarding their applicability for acute treatment of sucking chest wounds in pre-hospital emergency care, namely a commonly used rescue blanket (RB), plastic foil from a gauze package (packaging material, PM) and a commercial chest seal (CS).
RESULTS
An ex vivo open pneumothorax model using a porcine chest wall and a vacuum-assisted drainage system was successfully established. Rescue blanket segments sized 70 x 100 mm achieved significantly higher rates of successful sealing than did plastic foils from a gauze package sized 100 x 100 mm when the devices were applied to the moistened chest wall and fixed on three sides (5/5 (100%) vs. 0/5 (0%), p=0.002). Loosely fixed rescue blankets efficiently released injected air (10/10, 100%) and consequently sealed the wound in all cases (10/10).
CONCLUSIONS
Rescue blankets, applied wet, are appropriate chest seals with good occlusive and adherence properties. Fixation on two sides of the dressing is sufficient to allow trapped air to exit and sufficient sealing of the chest wound. Rescue blankets were superior to plastic foils from a gauze package and were seen to function as a potent makeshift chest seal when no commercial chest seal is available.
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