The earliest recorded reference to thoracic trauma is found in the Edwin Smith Papyrus, which is believed to be a copy of an older manuscript dating circa 3000 BC. Throughout the millennia, the management of chest injuries changed dramatically: from open packing and local treatment with common ingredients in the era of Hippocrates, to wound debridement and closure in the 13th century, and the use of closed drainage systems and thoracotomy during the World War II. Medical advances led to a substantial reduction in mortality from thoracic trauma, from a staggering 90% during the American Civil War to less than 10% in recent civilian experience. However, chest injuries continue to be associated with high mortality, accounting directly for approximately 25% of trauma-related deaths and contributing to another 25%. Furthermore, thoracic trauma results in significant morbidity, with nearly 1 in 4 patients requiring hospital admission, and it can cause long-term disability.
The adverse effects of thoracic trauma are the result of injury to the chest wall and/or vital intrathoracic structures either by blunt or penetrating mechanisms. Blunt trauma is responsible for over 70% of thoracic injuries, with the majority occurring in road traffic accidents. In these cases, the age of the patient plays a critical role in the severity of the injury and subsequent management. For instance, chest wall fractures are rare in paediatric patients, but intrathoracic injuries are more significant in this population. In elderly patients, mortality from thoracic trauma is high even with minor injuries. On the other hand, penetrating injuries are uncommon in patients at either end of the age spectrum, but they are the leading cause of hospitalisation and death from trauma in young individuals up to the fourth decade of life in both developed and developing countries.
It becomes apparent that thoracic trauma remains a global public health challenge. Despite the high prevalence of chest injuries and their negative social impact, there is a lack of standardized methodology to assess the severity of thoracic trauma and a relative paucity of clinical evidence to evaluate long-term outcomes produced by different interventions. Recent research on advanced imaging modalities, various analgesic techniques, and several methods of surgical stabilisation of fractures are steps in the right direction, but more is required to reduce the high burden of morbidity and mortality associated with thoracic trauma.
The primary aim of this Research Topic is to present recent advances in the assessment and management of thoracic trauma, with a greater focus on blunt injuries. Indicatively, potential themes could include surgical treatment of rib or other chest-wall fractures, systemic and regional analgesia for pain control, management of intrathoracic injuries, and rehabilitation for sequelae of thoracic trauma. To that end, we welcome all article types that are suitable for submission to the Thoracic Surgery section of Frontiers in Surgery. Hopefully, this Research Topic will serve to inform best practices and identify priorities for further research.
The earliest recorded reference to thoracic trauma is found in the Edwin Smith Papyrus, which is believed to be a copy of an older manuscript dating circa 3000 BC. Throughout the millennia, the management of chest injuries changed dramatically: from open packing and local treatment with common ingredients in the era of Hippocrates, to wound debridement and closure in the 13th century, and the use of closed drainage systems and thoracotomy during the World War II. Medical advances led to a substantial reduction in mortality from thoracic trauma, from a staggering 90% during the American Civil War to less than 10% in recent civilian experience. However, chest injuries continue to be associated with high mortality, accounting directly for approximately 25% of trauma-related deaths and contributing to another 25%. Furthermore, thoracic trauma results in significant morbidity, with nearly 1 in 4 patients requiring hospital admission, and it can cause long-term disability.
The adverse effects of thoracic trauma are the result of injury to the chest wall and/or vital intrathoracic structures either by blunt or penetrating mechanisms. Blunt trauma is responsible for over 70% of thoracic injuries, with the majority occurring in road traffic accidents. In these cases, the age of the patient plays a critical role in the severity of the injury and subsequent management. For instance, chest wall fractures are rare in paediatric patients, but intrathoracic injuries are more significant in this population. In elderly patients, mortality from thoracic trauma is high even with minor injuries. On the other hand, penetrating injuries are uncommon in patients at either end of the age spectrum, but they are the leading cause of hospitalisation and death from trauma in young individuals up to the fourth decade of life in both developed and developing countries.
It becomes apparent that thoracic trauma remains a global public health challenge. Despite the high prevalence of chest injuries and their negative social impact, there is a lack of standardized methodology to assess the severity of thoracic trauma and a relative paucity of clinical evidence to evaluate long-term outcomes produced by different interventions. Recent research on advanced imaging modalities, various analgesic techniques, and several methods of surgical stabilisation of fractures are steps in the right direction, but more is required to reduce the high burden of morbidity and mortality associated with thoracic trauma.
The primary aim of this Research Topic is to present recent advances in the assessment and management of thoracic trauma, with a greater focus on blunt injuries. Indicatively, potential themes could include surgical treatment of rib or other chest-wall fractures, systemic and regional analgesia for pain control, management of intrathoracic injuries, and rehabilitation for sequelae of thoracic trauma. To that end, we welcome all article types that are suitable for submission to the Thoracic Surgery section of Frontiers in Surgery. Hopefully, this Research Topic will serve to inform best practices and identify priorities for further research.
