Surgical and perioperative management of flail chest with titanium plates: a French cohort series from a thoracic referral center
Abstract 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...
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| Format: | Article |
| Language: | English |
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BMC
2023-01-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-023-02121-8 |
| _version_ | 1797945765053595648 |
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| author | Sarah Féray Clarisse Blayau Hicham Masmoudi Samuel Haddad Christophe Quesnel Jalal Assouad Muriel Fartoukh |
| author_facet | Sarah Féray Clarisse Blayau Hicham Masmoudi Samuel Haddad Christophe Quesnel Jalal Assouad Muriel Fartoukh |
| author_sort | Sarah Féray |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-10T21:00:18Z |
| format | Article |
| id | doaj.art-b8da5e3cf51a47bfb9cfcf2fbc3e11dd |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-04-10T21:00:18Z |
| publishDate | 2023-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-b8da5e3cf51a47bfb9cfcf2fbc3e11dd2023-01-22T12:24:53ZengBMCJournal of Cardiothoracic Surgery1749-80902023-01-011811910.1186/s13019-023-02121-8Surgical and perioperative management of flail chest with titanium plates: a French cohort series from a thoracic referral centerSarah Féray0Clarisse Blayau1Hicham Masmoudi2Samuel Haddad3Christophe Quesnel4Jalal Assouad5Muriel Fartoukh6Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Service de Médecine Intensive Réanimation, Sorbonne UniversitéAssistance Publique-Hôpitaux de Paris, Hôpital Tenon, Service de Médecine Intensive Réanimation, Sorbonne UniversitéAssistance Publique-Hôpitaux de Paris, Hôpital Tenon, Service de Chirurgie Thoracique et Vasculaire, Sorbonne UniversitéAssistance Publique-Hôpitaux de Paris, Hôpital Tenon, Service de Radiologie, Sorbonne UniversitéAssistance Publique-Hôpitaux de Paris, Hôpital Tenon, Service d’Anesthésie-Réanimation et Médecine Péri-operatoire, Sorbonne UniversitéAssistance Publique-Hôpitaux de Paris, Hôpital Tenon, Service de Chirurgie Thoracique et Vasculaire, Sorbonne UniversitéAssistance Publique-Hôpitaux de Paris, Hôpital Tenon, Service de Médecine Intensive Réanimation, Sorbonne UniversitéAbstract 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.https://doi.org/10.1186/s13019-023-02121-8Thoracic traumaFlail chestSurgical rib fracture fixationComplicationTTSS score |
| spellingShingle | Sarah Féray Clarisse Blayau Hicham Masmoudi Samuel Haddad Christophe Quesnel Jalal Assouad Muriel Fartoukh Surgical and perioperative management of flail chest with titanium plates: a French cohort series from a thoracic referral center Journal of Cardiothoracic Surgery Thoracic trauma Flail chest Surgical rib fracture fixation Complication TTSS score |
| 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 | Thoracic trauma Flail chest Surgical rib fracture fixation Complication TTSS score |
| url | https://doi.org/10.1186/s13019-023-02121-8 |
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