【Summary】Chest wall skin and soft tissue injuries are an important part of chest wall trauma, and their treatment is also like other chest wall surgery, with the properties of curing diseases and plastic surgery. These basic attributes must be kept in mind when managing such trauma, and only in this way can the operation be guided and a more satisfactory effect be obtained.
The chest wall is mainly composed of three components, namely bone, soft tissue and skin. The three components are an organic whole, and when the chest wall suffers trauma, all three components can be traumatized. In most cases, when talking about chest wall trauma, the emphasis is on trauma of bony structures, but skin and soft tissue injuries are equally important and require the same attention.
The various structures of the chest wall have their own unique functions. Bony structures are important and have their own functions. Skin and soft tissues are equally important and have their own unique functions. The skin is the protective barrier of the human body and the most important protective structure. In addition to the protective function, another function of the skin is the aesthetic function. These are the two most high-profile functions of the skin. Soft tissues of the chest wall include a variety of muscle, fat, and subcutaneous tissues, which also have special functions: (1) filling function. The main structure of the chest wall is bone, but there are a large number of gaps between the bones, and these gaps must have enough tissue to fill. Soft tissues happen to be the ideal structure to fill these gaps; (2) liaison function. The structure of the chest wall is diverse, and although there are various forms of communication between them, the most important contact is done by soft tissue. It is precisely because of the existence of soft tissues that the chest wall becomes an organic whole; (3) aesthetic function. The surface of the bony structure of the sternum wall is covered with a large number of soft tissues, which can effectively cover the shape of the bony structure and make the chest wall present a more beautiful appearance. If there is no soft tissue coverage, the contour of the bony structure will be revealed, which will seriously affect the appearance; (4) buffer function. When the bony structures of the chest wall collide with external structures, they can cause serious injuries. Soft tissue exists on the surface of the bone structure, has a satisfactory cushioning function, can effectively alleviate the collision of external forces, and plays a good cushioning role; (5) protection function. Soft tissues can not only protect the bone structure of the chest wall, but also play a protective role in blood vessels, nerves and other structures; (6) blood supply function. There are sufficient blood vessels inside the soft tissue, and these blood vessels not only provide a good blood supply for their weaving itself, but also provide sufficient blood for other structures of the chest wall, so they have a good blood supply function; (7) nutritional function. Adequate blood circulation of soft tissues can provide satisfactory nutrition for various structures with good nutritional function.
Both skin and soft tissues have important functions, and once damaged, a number of problems will arise. From the nature of the injury, skin soft tissue injuries are generally divided into three types: contusions, lacerations and contusions. This statement is not complete, because the most severe time will appear the loss of soft tissues of the skin, which is actually a manifestation of defects.
When the injury occurs, the corresponding symptoms will appear in the local area of the chest wall, the most important symptom is pain, and the corresponding signs will appear in the damaged area. The diagnosis of skin and soft tissue damage is not difficult, considering that it is often accompanied by other structural injuries, so when making a diagnosis, it is necessary to take into account the possibility of injury to other parts of other structures to avoid missing the diagnosis.
The clinical manifestations of skin and soft tissue injuries are complex and varied, and treatment measures vary greatly. Simple skin contusions are mainly treated by regular dressing changes. Simple skin lacerations can be sutured on the basis of debridement. Simple skin contusions also require debridement before suturing. When the skin and soft tissues are damaged at the same time, it needs to be properly managed according to the situation, and in severe cases, a flap transplant is required.
Surgical treatment of skin and soft tissue injuries is an element of chest wall surgery, so strictly speaking, it also has the same therapeutic and plastic properties. The above treatment content can be regarded as the content of curing the disease, and it already contains plastic components. It must be pointed out that only when the properties of plastic surgery are valued, the effect of surgery can be more perfect and more recognized by the injured person.