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Lutheran Medical Center

Trauma Surgery

Trauma surgery is enhanced type general surgery that includes treating those injured in car accidents, bicycle or motorcycle accidents, trips and falls, skiing or snowboarding accidents, as well as many other unforeseen activity-related injuries.

We specialize in trauma surgeries, such as:

Abdominal trauma

Patients with severe abdominal trauma may require surgery to fix uncontrollable bleeding or injury to the internal organs (liver, spleen, kidneys, pancreas, intestines, etc.). Some patients may have injuries to solid organs (liver or spleen) which does not require surgery, but does require close monitoring in the hospital and follow up for a couple months after the injury.

Blunt abdominal trauma is regularly encountered in the emergency department. Victims of blunt trauma often have other injuries as well. Blunt abdominal trauma most often results from car/ bike/ motorcycle accidents, pedestrians hit by a vehicle, direct blow to the belly (hit, kicked, tackles in contact sports), and falls (from height or from standing).

The spleen is the most commonly injured organ, followed by the liver and kidneys. Less commonly, the gastrointestinal tract (the intestines) can be injured as well.

In car accidents, passengers wearing a lap-belt without a shoulder attachment can suffer injury from the seatbelt forcefully compressing the abdomen. Tearing forces created by sudden stopping can cause injuries of both solid organs (liver, spleen, kidneys) and hollow organs (intestines) at their points of attachment to the abdominal cavity.

Broken ribs or pelvic bones can also lacerate (or cut into) abdominal organs.

Unrestrained (not wearing a seatbelt) victims are at higher risk of injury than those who are restrained (wearing a seatbelt)

Diagnostic tests

A variety of diagnostic tests can be used to determine abdominal injuries including:

  • An ultrasound of the abdomen, usually performed in the Emergency Room, to determine if there is blood in the abdominal cavity.
  • A CT scan of the chest and abdomen which looks at the bones and the soft tissues.

Chest trauma

Chest trauma includes fractures of the ribs and/or sternum (breast bone), or sometimes severe bruising to the chest without fractures. This can be very painful and may require treatment in the hospital. This may also require surgery to remove blood or air from the chest cavity, or to fix the fractures.

General trauma

As general surgeons, we also oversee all patients that are injured (trauma) and seen at Good Samaritan Medical Center, including anything from a minor fall to multiple severe injuries from a high-speed motorcycle accident, and everything in between. Some of these injuries may require surgery, sometimes from a general surgeon or sometimes from specialist surgeons (such as neurosurgeon or orthopedic surgeon; some injuries do not require surgery but may still require treatment in the hospital and close follow up, depending on the type and severity of injuries.

<>Surgical Care

To help our patients heal faster and more completely, we approach treatment as a team effort so that you are totally confident in our plan for treatment and surgery if necessary.We routinely provide surgical care for:

Surgery for thoracic trauma

Surgery for Pneumothorax or hemothorax: If a chest tube is not enough to remove the air or blood in the chest cavity, your doctor might need to do surgery. This surgery is called “thoracoscopy (meaning a scope in the chest) or VATS (Video-assisted Thoracic Surgery).” This is “minimally invasive surgery” of the chest, similar to laparoscopic surgery of the belly.

During thoracoscopy, the doctor will give you medicine to make you sleep; it will be done under general anesthesia. Then he or she will make 2 or 3 small cuts between the ribs in your chest. He or she will put long, thin tools in these openings and into the space where the air collected. One of the tools has a camera on the end, which sends pictures to a TV screen. The doctor can look at the image on the screen to do the surgery.

Sometimes this cannot be completed using thoracoscopy, and in some cases it will require open chest surgery (this is called thoracotomy) to clean out the fluid in your chest.

Risks of Chest Surgery Include (but not limited to):

  • Bleeding
  • Infection in the chest or wounds
  • Injury to the lungs or heart, or other important structures in the chest
  • Need for further surgery or other procedures

Recovery after Chest Surgery for Trauma

After surgery you will have one or more chest tubes in your chest to continue draining the fluid. You will need to stay in the hospital for 3-7 days, or more, as you recover. You will need to stay in the hospital while the chest tube is in place. The chest tube will be followed by examination and Chest X-rays.

You will be sore for several weeks. Your doctor will also recommend a treatment to help prevent your small airways from closing off. This treatment, called “incentive spirometry,” involves breathing deeply into a hand-held device a number of times each day. It is also very important that you do not stay in bed. Activity, such as walking, although it can be painful, is very important to keep good lung function and to prevent pneumonia. When you are sent home from the hospital, you should walk around your house several times per day, and increase your activity as you can tolerate.

**You should also ask your doctor when you can fly in an airplane again. You will generally need to wait at least 2 weeks, and up to 12 weeks, before flying in an airplane or traveling to areas of elevation higher than 8000ft, as these altitude and pressure changes can cause the lung to re-collapse if the lung is not yet healed.

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