Comparison Of Surgical Fixation And Nonsurgical Management In Flail Chest Patients Who Combined With Pulmonary Contusion

Objective: To compare the clinical efficacy of surgical fixation and nonsurgicalmanagement in flail chest patients who combined with pulmonary contusion and tocompare the different timing of surgery so as to discuss the experience of themanagement.Methods:39patients who were diagnosed flail chest with pulmonarycontusion were chosen from our ICU department and analyzed retrospectively, fromJuly,2010to Dec,2013. All of them needed ventilator support. They were dividedinto surgical group and nonsurgical group according to the treatment method. Theclinical dates, such as duration of mechanical ventilation, ICU length of stay, hospitallength of stay, duration of antibiotic use, blood product use, expenditure, rate oftracheotomy, occurrence of pleural effusion, occurrence of ventilator relatedpneumonia and mortality were collected from all the subjects. The surgical group wasfurther divided into2groups according to the timing of surgery. Within7days ofoperation was defined as early surgery, the remaining was defined as later one. Theclinical dates, such as duration of mechanical ventilation, ICU length of stay, hospitallength of stay, duration of antibiotic use, blood product use, expenditure, rate oftracheotomy, occurrence of pleural effusion, occurrence of ventilator relatedpneumonia, occurrence of wound infection and mortality were also collected.Results: The surgical group and the nonsurgical group had no significantdifference in all the clinical results. Early surgical group could shorten the durationof mechanical ventilation（8.92±7.38VS15.58±4.54, p=0.014）, ICU length of stay（20.45±8.32VS30.42±11.32, p=0.027） and rate of tracheotomy（3/12VS9/12,p=0.039）, the remaining results also had no significant difference.Conclusions: Improvement had not been shown in any clinical result insurgical group compared to nonsurgical group. Early surgery could reduce DMV, ICULOS and rate of tracheotomy.