Damage control surgery in the traumatic lesions of the subclavian vessels

[摘要] INTRODUCTION. The traumatisms of the subclavian vessels are rare in our environment. Generally, they are exsanguinating lesions that may compromise life in a few minutes. The objective of the present investigation was to determine the results obtained in the control surgery of the subclavian vessel damage.METHODS. A prospective longitudinal study was conducted among 15 patients that received attention at the emergency centre of "Dr. Carlos J. Finlay" University Hospital due to penetrating lesions of the thorax between Janaury 1999 and January 2006. The data were consecutively collected and processed by the statistical system ISSP for Windows.RESULTS. The most frequent symptoms were thoracic pain (85 %) and shock signs. The penetrating stab wound was the most frequent cause (80 %). Book thoracotomy was performed in 9 patients with satisfactory results. 80 % of the patients underwent emergency surgery. The most frequent indication was hypovolemic shock (89 %) associated with penetrating traumatism. The wound of the subclavian artery caused by penetrating trauma was associated with pleuropulmonary lesion in 75 % of the patients. The mortality of the series was 33.34 %. The most common postoperative complication was the wound sepsis (5 %), followed by thoracic pain (4 %).CONCLUSIONS. It was concluded that this type of surgical approach is advantageous to repair the subclavian vessels and that it improves the mortality rate from these lesions. Book thoracotomy allows the proximal control of the subclavian artery and proves to be effective as a method to stop exsanguination.

[学科分类] 外科医学

[关键词] Subclavian vessels;book thoracotomy;exsanguniation.