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An unstable patient with a large sucking chest wound managed with gauze packing for preventing tension and bleeding control before surgery in Korea: a case report

  • Chang-Sin Lee (Department of Acute Care Surgery, Korea University Guro Hospital, Korea University College of Medicine) ;
  • Min-Jeong Cho (Department of Acute Care Surgery, Korea University Guro Hospital, Korea University College of Medicine) ;
  • Tae-Wook Noh (Department of Acute Care Surgery, Korea University Guro Hospital, Korea University College of Medicine) ;
  • Nak-Jun Choi (Department of Acute Care Surgery, Korea University Guro Hospital, Korea University College of Medicine) ;
  • Jun-Min Cho (Department of Acute Care Surgery, Korea University Guro Hospital, Korea University College of Medicine)
  • Received : 2023.09.18
  • Accepted : 2023.11.29
  • Published : 2024.06.30

Abstract

This case report describes the management of a 51-year-old female patient who arrived at the emergency room with a stab wound to the upper right chest. Immediate medical interventions were undertaken, including blood transfusions and endotracheal intubation. To prevent tension and control bleeding, gauze packing was applied directly through the large open wound. Further surgical exploration identified a laceration in the lung, necessitating a right upper lobe resection. Postoperatively, the patient's vital signs stabilized, and she was subsequently discharged without complications. This case highlights the decision-making process in selecting between an emergency department thoracotomy and an operating room thoracotomy for patients with penetrating chest trauma. It also illustrates the role of gauze packing in managing tension and hemorrhage. In summary, gauze packing can be an effective interim measure for stabilizing patients with traumatic injuries, unstable vital signs, and large open chest wounds, particularly when a chest tube is already in place, to prevent tension and facilitate bleeding control prior to surgical intervention.

Keywords

References

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