In a large cohort of war casualties in Vietnam, the majority of chest injuries were successfully managed with tube drainage, while popliteal artery repairs had a high failure rate.
Provides benchmarks for penetrating trauma; leaves open whether modern techniques have lowered negative laparotomy and vascular failure rates.
The continuous surgical experience of the 27th Surgical Hospital in Chu Lai, Vietnam, from March 1968 through February 1970 and includes 7,314 surgical admissions and 5,231 major operations. Of 624 chest injuries requiring chest tubes only 104 (16.5%) required thoracotomy, thus indicating that the majority can be handled by tube drainage. "Contused lung," in which the injury is localized and symptoms uncontrollable may be a definite indication for lobectomy. There were 1,409 laparotomies in which 1,741 organ injuries were found. The negative exploration rate was 13.5%. Of 171 vascular repairs, there were 29 failures (17%). The failure rate was highest for popliteal artery repair at 35%. This is similar to the experience of others and may reflect either inexperience or an approach that is too conservative towards initial amputation.
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LTC James E. Oglesby (1971) studied this question.
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