Our Summary

This research study looked at what factors could predict the likelihood of death in trauma patients who underwent a specific surgical procedure, sternotomy for hemorrhage control (SHC), which is a surgery to stop bleeding by opening the chest. The researchers examined data from adult trauma patients who had this surgery within 24 hours of being admitted to a hospital between 2013 and 2016.

They compared patients who had suffered blunt trauma (like a car crash) with those who had penetrating trauma (like a gunshot wound). They found that the group of patients who had suffered blunt trauma had more severe injuries, took longer to stop the bleeding, and also had a higher death rate compared to the group with penetrating trauma.

However, when they took other factors into account (like the age and overall health of the patient), there wasn’t a significant difference in the risk of death between the two groups. This is despite the fact that it took almost twice as long to control the bleeding in patients with blunt trauma. So, the type of trauma (blunt vs. penetrating) doesn’t necessarily predict the likelihood of death after this kind of surgery.

FAQs

  1. What is sternotomy for hemorrhage control (SHC)?
  2. What were the main findings of the research study on trauma patients who underwent SHC between 2013 and 2016?
  3. Does the type of trauma (blunt vs. penetrating) predict the likelihood of death after sternotomy for hemorrhage control surgery?

Doctor’s Tip

One helpful tip a doctor might give to a patient who has undergone sternotomy is to follow post-operative care instructions closely. This may include taking prescribed medications, keeping the incision site clean and dry, avoiding strenuous activities, and attending follow-up appointments. By following these instructions, the patient can help ensure proper healing and reduce the risk of complications.

Suitable For

Patients who are typically recommended sternotomy for hemorrhage control are those who have suffered severe trauma resulting in significant bleeding that cannot be controlled through other means. This may include patients with penetrating trauma such as gunshot wounds or stab wounds, as well as patients with blunt trauma such as injuries from car accidents or falls. The decision to perform a sternotomy for hemorrhage control is typically made in cases where other interventions have been unsuccessful in stopping the bleeding and the patient’s condition is deteriorating rapidly.

Timeline

Before sternotomy:

  • Patient experiences trauma that results in severe bleeding
  • Patient is admitted to the hospital and evaluated for the need for surgery
  • Decision is made to perform sternotomy for hemorrhage control
  • Patient undergoes pre-operative preparation, including consent and anesthesia

After sternotomy:

  • Surgeon opens the chest through a vertical incision in the sternum
  • Bleeding is controlled and any damaged tissues are repaired
  • Patient is monitored closely in the intensive care unit post-operatively
  • Recovery period includes pain management, physical therapy, and monitoring for complications
  • Patient is discharged from the hospital once stable and able to continue recovery at home.

What to Ask Your Doctor

  1. What is the purpose of sternotomy for hemorrhage control (SHC) and why is it being recommended for me?

  2. What are the potential risks and complications associated with sternotomy?

  3. How long is the recovery process after undergoing a sternotomy procedure?

  4. What is the success rate of sternotomy for hemorrhage control in patients with similar conditions to mine?

  5. Are there any alternative treatments or procedures that could be considered instead of sternotomy for hemorrhage control?

  6. How long will I need to stay in the hospital after undergoing a sternotomy procedure?

  7. What is the long-term prognosis after undergoing sternotomy for hemorrhage control?

  8. Are there any lifestyle changes or precautions I should take after undergoing a sternotomy procedure?

  9. How frequently will I need follow-up appointments or tests after undergoing sternotomy for hemorrhage control?

  10. Are there any specific warning signs or symptoms I should watch out for after undergoing a sternotomy procedure that may indicate a complication?

Reference

Authors: Duong W, Grigorian A, Al-Khouja L, Schubl S, Kong A, Lekawa M, Chin TL, Nahmias J. Journal: J Surg Res. 2020 Mar;247:227-233. doi: 10.1016/j.jss.2019.09.071. Epub 2019 Nov 20. PMID: 31759620