The optimal physiotherapeutic approach to penetrating stab wounds of the chest

Abstract

Penetrating injuries to the chest are among the most common injuries seen in the casualty department at Hillbrow Hospital, Johannesburg. Opinions regarding the surgical handling of patients with penetrating chest trauma continue to differ. The purpose of this study was to determine whether there would be a difference in outcome in patients who receive chest physiotherapy immediately after insertion of the intercostal drain versus those patients who receive chest physiotherapy nine to twelve hours later. In an effort to optimise the physiotherapy management of patients with penetrating stab wounds to the chest, a comparative study was conducted at Hillbrow Hospital, Johannesburg. Twenty six male patients between the ages of eighteen to thirty years were randomly allocated to one of two groups on admission to the Hospital. The patients in Group I received chest physiotherapy immediately after insertion of the intercostal drain while patients in Group II received chest physiotherapy nine to twelve hours later. Mean duration of time of intercostal drainage in Group I was 40 hours and in Group II 65,92 hours. Patients in Group I had a mean hospital stay of 43,96 hours, while patients in Group II had a mean hospital stay of 77,53 hours. The prevalence of patients with spiking temperatures was also significantly lower in Group I than in Group II. This study suggests that the protocol of an aggressive approach of immediate chest physiotherapy in these patients has definite beneficial results.