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Master Thesis

Prise en charge des traumatismes thoraciques fermés : analyse exploratoire de l'expérience d'un centre hospitalo-universitaire médico-chirurgical thoracique

Abstract : We report the experience of the patients management referred in intensive care unit (ICU) for rib fracture fixation after isolated closed chest trauma. The development of titanium claw plates of the Stracos™ system makes easy to achieve rib osteosynthesis. This new technology has led to a renewed interest in this surgery. This retrospective observational cohort study aims to describe the characteristics of the patients, the surgical procedure, to analyze the intra hospital outcome and to identify possible risk factors for postoperative complications. All patients admitted to the ICU of the University Hospital of Tenon from November 1, 2013 until December 31, 2016 for the postoperative management of rib fracture fixation were evaluated. 42 consecutive patients were admitted. Trauma was severe with TTSS of 11.0 [9-12] and a median number of broken ribs of 7 [5-8.75]. The majority of patients were not in acute respiratory failure before surgery with only 6 patients on mechanical ventilation. A postoperative complication (acute respiratory failure, hemodynamic failure, renal failure, postoperative pneumonia, surgical site infection or death in ICU) occurred in 18 patients (43%). Five patients developed ARDS (12%), postoperative pneumonia occurred in 11 patients (26%). Two patients died in ICU. In multivariate analysis, the TTSS (OR=1.89; IC95% 1.12 - 3.17; p=0.016) and the IGSII score without age (OR=1.17; IC95% 1.02 - 1.34; p=0.024) were independently associated with the occurrence of a postoperative complication. Rib fracture fixation surgery involves risks and its short and long-term benefit must be assessed.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03192627
Contributor : Université Paris Descartes - Scd <>
Submitted on : Thursday, April 8, 2021 - 10:53:19 AM
Last modification on : Friday, September 3, 2021 - 3:32:56 AM

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Sarah Féray. Prise en charge des traumatismes thoraciques fermés : analyse exploratoire de l'expérience d'un centre hospitalo-universitaire médico-chirurgical thoracique. Médecine humaine et pathologie. 2019. ⟨dumas-03192627⟩

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