REDUCE, REPAIR, RESTORE – A CASE SERIES OF CHEST WALL RECONSTRUCTION IN THORACIC TRAUMA AT A LEVEL 1 TRAUMA CENTRE IN INDIA. dr.mahalakshmimanoharan@gmail.com

PW05-13

REDUCE, REPAIR, RESTORE – A CASE SERIES OF CHEST WALL RECONSTRUCTION IN THORACIC TRAUMA AT A LEVEL 1 TRAUMA CENTRE IN INDIA.

7

India

Oral or Poster

High-energy injuries leading to chest wall distortion can be life-threatening and severely debilitating if not addressed promptly. This case series presents our experience with eight patients who underwent chest wall reconstruction following thoracic trauma.

A retrospective case series was conducted at a Level I trauma centre between January 2024 and June 2025, involving eight patients who underwent chest wall reconstruction. Six patients underwent Surgical Stabilization of Rib Fractures (SSRF) using titanium plating systems. One patient with multiple open, comminuted rib fractures was managed using polyester suture approximation, while another with an open sternal fracture was repaired using stainless steel wires. Data collected included demographic details,mechanism of injury, injuries sustained,injury severity score,indication for surgery,operative details, ventilator days, postoperative complications, and functional outcomes.

Blunt trauma was the predominant mechanism (n=7), with one case of penetrating trauma. Most patients were males aged 16–55. The mean Injury Severity Score (ISS) was 22. Indications included failure to wean due to volume loss (n=3), flail chest (n=3), and open thoracic injuries (n=2), often associated with respiratory distress. The mean ICU stay was 4.5 days (range: 2–7), with early ventilator weaning (mean: 3.5 days post-op). Follow-up showed satisfactory radiological healing and early return to work. One patient developed a biliary fistula with exposed implant, which was managed with ERCP and a rhomboid flap for coverage.

Tailored chest wall reconstruction approaches, including SSRF and non-implant techniques, provide promising outcomes. Even in resource-limited settings, timely reconstruction using non implant methods remains a safe, viable and effective option.