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Surgical and perioperative management of flail chest with titanium plates: a French cohort series from a thoracic referral center
BACKGROUND: The development of titanium claw plates has made rib osteosynthesis easy to achieve and led to a renewed interest for this surgery. We report the management of patients referred to the intensive care unit (ICU) of a referral center for surgical rib fracture fixation (SRFF) after chest tr...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9850677/ https://www.ncbi.nlm.nih.gov/pubmed/36653803 http://dx.doi.org/10.1186/s13019-023-02121-8 |
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author | Féray, Sarah Blayau, Clarisse Masmoudi, Hicham Haddad, Samuel Quesnel, Christophe Assouad, Jalal Fartoukh, Muriel |
author_facet | Féray, Sarah Blayau, Clarisse Masmoudi, Hicham Haddad, Samuel Quesnel, Christophe Assouad, Jalal Fartoukh, Muriel |
author_sort | Féray, Sarah |
collection | PubMed |
description | BACKGROUND: The development of titanium claw plates has made rib osteosynthesis easy to achieve and led to a renewed interest for this surgery. We report the management of patients referred to the intensive care unit (ICU) of a referral center for surgical rib fracture fixation (SRFF) after chest trauma. METHODS: We performed a retrospective observational cohort study describing the patients’ characteristics and analyzing the determinants of postoperative complications. RESULTS: From November 2013 to December 2016, 42 patients were referred to our center for SRFF: 12 patients (29%) had acute respiratory failure, 6 of whom received invasive mechanical ventilation. The Thoracic Trauma Severity Score (TTSS) was 11.0 [9–12], with 7 [5–9] broken ribs and a flail chest in 92% of cases. A postoperative complication occurred in 18 patients (43%). Five patients developed ARDS (12%). Postoperative pneumonia occurred in 11 patients (26%). Two patients died in the ICU. In multivariable analysis, the Thoracic Trauma Severity Score (TTSS) (OR = 1.89; CI 95% 1.12–3.17; p = 0.016) and the Simplified Acute Physiology Score II without age (OR = 1.17; CI 95% 1.02–1.34; p = 0.024) were independently associated with the occurrence of a postoperative complication. CONCLUSION: The TTSS score appears to be accurate for determining thoracic trauma severity. Short and long-term benefit of Surgical Rib Fracture Fixation should be assessed, particularly in non-mechanically ventilated patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13019-023-02121-8. |
format | Online Article Text |
id | pubmed-9850677 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-98506772023-01-20 Surgical and perioperative management of flail chest with titanium plates: a French cohort series from a thoracic referral center Féray, Sarah Blayau, Clarisse Masmoudi, Hicham Haddad, Samuel Quesnel, Christophe Assouad, Jalal Fartoukh, Muriel J Cardiothorac Surg Research BACKGROUND: The development of titanium claw plates has made rib osteosynthesis easy to achieve and led to a renewed interest for this surgery. We report the management of patients referred to the intensive care unit (ICU) of a referral center for surgical rib fracture fixation (SRFF) after chest trauma. METHODS: We performed a retrospective observational cohort study describing the patients’ characteristics and analyzing the determinants of postoperative complications. RESULTS: From November 2013 to December 2016, 42 patients were referred to our center for SRFF: 12 patients (29%) had acute respiratory failure, 6 of whom received invasive mechanical ventilation. The Thoracic Trauma Severity Score (TTSS) was 11.0 [9–12], with 7 [5–9] broken ribs and a flail chest in 92% of cases. A postoperative complication occurred in 18 patients (43%). Five patients developed ARDS (12%). Postoperative pneumonia occurred in 11 patients (26%). Two patients died in the ICU. In multivariable analysis, the Thoracic Trauma Severity Score (TTSS) (OR = 1.89; CI 95% 1.12–3.17; p = 0.016) and the Simplified Acute Physiology Score II without age (OR = 1.17; CI 95% 1.02–1.34; p = 0.024) were independently associated with the occurrence of a postoperative complication. CONCLUSION: The TTSS score appears to be accurate for determining thoracic trauma severity. Short and long-term benefit of Surgical Rib Fracture Fixation should be assessed, particularly in non-mechanically ventilated patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13019-023-02121-8. BioMed Central 2023-01-18 /pmc/articles/PMC9850677/ /pubmed/36653803 http://dx.doi.org/10.1186/s13019-023-02121-8 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Féray, Sarah Blayau, Clarisse Masmoudi, Hicham Haddad, Samuel Quesnel, Christophe Assouad, Jalal Fartoukh, Muriel Surgical and perioperative management of flail chest with titanium plates: a French cohort series from a thoracic referral center |
title | Surgical and perioperative management of flail chest with titanium plates: a French cohort series from a thoracic referral center |
title_full | Surgical and perioperative management of flail chest with titanium plates: a French cohort series from a thoracic referral center |
title_fullStr | Surgical and perioperative management of flail chest with titanium plates: a French cohort series from a thoracic referral center |
title_full_unstemmed | Surgical and perioperative management of flail chest with titanium plates: a French cohort series from a thoracic referral center |
title_short | Surgical and perioperative management of flail chest with titanium plates: a French cohort series from a thoracic referral center |
title_sort | surgical and perioperative management of flail chest with titanium plates: a french cohort series from a thoracic referral center |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9850677/ https://www.ncbi.nlm.nih.gov/pubmed/36653803 http://dx.doi.org/10.1186/s13019-023-02121-8 |
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