Penetrating XXXX in civilian practice.

@entity1 @entity295 @entity548 @entity2982 @entity764 @entity1576
The purpose of this retrospective study is to show the pattern of penetrating @entity764 , methods of management and the outcome. Were viewed all consecutive penetrating chest injured @entity1 admitted to the Cardiothoracic Surgical Unit of the University College Hospital, Ibadan between May 1975 and April 1999. We found that 597 @entity1 had penetrating @entity764 . This was 31% of all @entity764 treated. To analyse pattern of injuries, period of study was divided into 2 periods of 12 years each, May 1975 to April 1987 (Group A) and May 1987 to April 1999 (Group B). Mean ages of the @entity1 in group A and B were, respectively, 27 +/- 12.5years and 48 +/- 10.2 years; male:female ratio for the 2 groups were 20:1 and 17:1, respectively. The main mechanisms of injury were gunshot wounds (GSW) in 364 @entity1 (61%) and stab wounds (SW) in 214 @entity1 (35.8%). The ratio of GSW to SW was reversed for the 2 periods, 1:3 for group A and 7:1 for group B. Nine @entity1 died during resuscitation. Four hundred and eleven @entity1 of 588 @entity1 (69.9%) were managed conservatively. Sixty-five (11.1%) by clinical observation and 346 (58.8%) by closed thoracostomy drainage. Mortality among the conservatively managed was 2.2%, morbidity was 18.2% (75 out of 411 @entity1 ). Ninety @entity1 had early major surgery, 75 had late major surgical management of complication of conservative management. The operative mortality was 22% (in 39 @entity1 ). The determinant of mortality were @entity548 , @entity1576 and @entity295 . We conclude that @entity2982 is a third of @entity764 we see. It is commoner in @entity1 and currently involves the older age group and it is most frequently inflicted by gunshot. Majority may be managed conservatively with low incidence of complications. Prompt major surgery limits mortality among the salvageable.
