Operative management of penetrating wounds of the chest. Experience with 41 patients on the island of Curaçao.

Of the 157 cases of chest injuries, 41 patients underwent thoracotomy. Thirty-three were male and 7 female with an average age of 27 years. Eighty-three percent had stabwounds and 17 percent gunshotwounds . On admission and on examination only seven thoracotomy patients were in a stable clinical condition. Hypotension and hemo- or pneumothorax were often present. Persisting hemorrhage from chest tubes drainage, cardiac tamponnade , and massive hemothorax were indications for immediate thoracotomy. Only few of the patients with an hemothorax have an hemorrhage from a major systemic vessel. Associated intraabdominal injuries were often found (17%). For exploration of the abdominal lesions a separate explorative laparotomy is indicated. The only patient who died in our series suffered from septicemia after multiple associated intra-abdominal wounds (mortality rate 2.4%). The overall complication rate was 19.7%. The average period of hospitalisation was 15.4 days.