Chest wall trauma is also a surgical disease of the chest wall, so the treatment of wounds has the properties of healing and plastic surgery. The curative attribute refers to the direct treatment of the traumatic wound, which can be included in the plastic surgery or can be an additional operation. The overall purpose of plastic surgery is to obtain the desired appearance, and the results can be divided into three levels: (1) Primary plastic surgery effect. Ensure normal physiological function and appearance close to normal; (2) intermediate plastic surgery effect. Normal physiological function, chest wall shape is basically normal; (3) advanced plastic surgery effect. The appearance is not only normal but also beautiful. In the specific treatment process, if the trauma is extremely serious, it is necessary to achieve the effect of primary plastic surgery as much as possible. If the trauma is not too severe, the effect of intermediate plastic surgery should be achieved as much as possible. After great efforts, if you can get the results of advanced plastic surgery, it will be the most satisfactory result.
The specific treatment of the wound includes three aspects of work: one is the implementation of the incision, the second is the treatment inside the wound, and the third is the suture of the incision.
Wounds generally occur in open chest wall trauma, and the incision should be designed as far as possible at the skin wound, if the deep injury site is far away from the wound, it is necessary to make incisions in other parts, but the skin wound must be fully utilized. Closed chest wall trauma has no skin wounds, and if deep structural damage needs to be treated, an incision must also be made, at this time the incision should be as short and hidden as possible under the premise of ensuring exposure, and can be selected under the armpit or other special parts, such as the folds of the skin under the female breast.
When open chest wall trauma occurs, skin wounds may have different shapes, and they need to be trimmed according to the specific situation when treated, so that the postoperative scars do not affect the appearance as much as possible. In addition, during the operation, it is also necessary to protect the incision as much as possible to prevent additional damage to the incision, and the injury will increase the postoperative scarring.
After the incision is revealed, the inside of the wound needs to be treated next. The basic principle of processing is to preserve useful structures and remove useless structures. Whether for the skin, soft tissues or bone structure, it should be preserved as much as possible. If there is obvious necrosis or contamination, it is removed.
In order to obtain a good appearance, when treating the bony structure, it is necessary to ensure that there are no deformities. If there is a defect in the chest wall, reconstruction is required. The principle of reconstruction is the same as that of reconstruction of chest wall defects, and the reconstruction of three basic structures needs to be taken into account.
After the operation inside the wound is treated, it is necessary to completely stop the bleeding, then rinse and disinfect, and if necessary, place a suitable drainage. The final step in wound treatment is suturing. This step is particularly important because it is not only related to the healing of the incision, but also to the aesthetic problems after surgery.
Chest wall trauma is a relatively common injury, and the management of the wound is the most basic operation. When dealing with wounds, it is necessary to always keep in mind the properties of healing and plastic surgery, only in this way can the desired results be obtained.