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March 1964

Treatment of Penetrating Wounds Of the Chest

Arch Surg. 1964;88(3):397-404. doi:10.1001/archsurg.1964.01310210071011

Introduction  The management of penetrating wounds of the chest has changed significantly in recent years. Previously, delayed evacuation of hemothorax or pneumothorax with thoracentesis had been advocated as the definitive method of removing either air or blood from the pleural cavity. More recently prompt aspiration has been practiced and thoracostomy tube drainage instituted for persistent air leak or massive hemorrhage.At Kings County Hospital Center immediate and complete evacuation of any significant hemothorax or pneumothorax by closed thoracostomy has been the procedure of choice. Needle aspiration has been reserved for small air or fluid collection or for patients treated later than 24 hours after injury. Because the morbidity and mortality with this plan of management appears to have been relatively small, we have reviewed our experience from January, 1955 through December, 1961.

Material  The records of 301 consecutive patients with penetrating thoracic wounds admitted alive to the receiving room of

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