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Trauma thoracotomy was first instituted more than 40 years ago, and, although the American College of Surgeons Committee on Trauma (ACSCOT) has since developed guidelines for when the procedure should be performed (e.g., not in patients with blunt trauma or asystole), definitive indications have not been established. In the first prospective study of its kind, researchers analyzed data for 56 patients (age range, 15–64; 93% men) who survived trauma thoracotomy at 18 U.S. trauma centers from 2003 to 2009. Each center followed its own protocol for the procedure.
Injury mechanism was stab wound in 53% of patients, gunshot wound in 38%, and blunt trauma in 9%. The most common injuries were ventricular stab wound (30%) and gunshot wound to the lu…