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Old 03-30-2009, 16:55   #12
crash
Guerrilla
 
Join Date: Sep 2006
Posts: 123
Question

Quote:
Originally Posted by swatsurgeon View Post
An open wound BTW is a safe wound just like a 'simple' PTX....air exchanges and based on negative pressure ventilation (our usual method of breathing) vast majority of patients will do fine....if any problems, BVM or intubate and provide positive pressure ventilation then the open chest is a100% non-issue.
Controlling contamination is another but related issue.
ss
By sealing the wound you give it the chance to build pressure and become a pneumothorax; but wouldn't using a chest seal with a one way valve prevent pressure from building?

Preventing outside air from coming in, would allow for negative pressure in the chest when the diaphragm contracts, which the lungs need to inflate/pull ambient air in. If you leave the wound open when the diaphragm contracts wouldn't it just pull ambient air into the plural space through the wound instead of into the lungs?

With air pressure around the lung the same as the ambient, wouldn't positive pressure ventilation be necessary?

Also what are your thoughts on keeping the wound clean if left open? Wrap loosely with kerlix, keeping debris out while still allowing air to pass through?
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Last edited by crash; 03-30-2009 at 16:59. Reason: spelling.
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