Made Jayawisesa Priyambhada Putra, Muhammad Teguh hadinata, Made Sopan Pradnya Nirartha
BACKGROUND: Open pneumothorax is an injury caused by sharp trauma or blunt, causing the thoracic cavity to open and air can enter from the outside. Open pneumothorax is a potentially lethal illness that requires cautious early management and the mortality rate was found to be 33%. In general, a chest tube is used to establish the negative pressure in the thorax cavity and facilitate redevelopment of the pulmo to assist remove air from the intrathoracic space. Antibiotics are usually given to prevent infection in the patient. We will report a case related to the effectiveness of using antibiotics as infection prevention in open pneumothorax post chest tube. CASE REPORT: We report a case of a 20-year-old man that was presented to our emergency department after got a traffic accident. The patient complained of chest pain, shortness of breath, and no other complaints. The patient was found to have an open wound on the right chest, measuring 5 x 3 cm with a lung wound base, and active bleeding. The patient's chest was found to be hyper resonant, decreased vesicular breath sounds, and asymmetry in physical examination. The patient was diagnosed with open pneumothorax and further instruction was surgical disposition. There were no radiological abnormalities on the chest x-ray of this patient. The main therapy, in this case, was the administration of antibiotics and the installation of a chest tube. The patient experienced postoperative pain after the insertion of a chest tube. Complete blood counts showed relatively normal results after three days and the patient stated that his complaints had decreased after four days. Two weeks later, the patient's previous complaints had not been felt. This condition indicates that there is no infection in the patient that can be associated with the administration of antibiotics. The therapy process is continued with chest physiotherapy until ten weeks later. CONCLUSION: The administration of antibiotics to this patient with open pneumothorax post chest tube indicated an effective result. Further research is needed to support the existing literature sources regarding open pneumothorax.
背景:开放性气胸是由尖锐创伤或钝器引起的损伤，导致胸腔打开，空气可以从外部进入。开放性气胸是一种潜在的致命疾病，需要谨慎的早期治疗，死亡率为33%。通常，胸管用于在胸腔内建立负压，并促进胸腔的再开发，以协助清除胸腔内的空气。通常给予抗生素是为了防止病人感染。我们将报告一例有关使用抗生素预防开放性气胸胸管后感染的有效性的病例。病例报告:我们报告一个20岁的男子，在发生交通事故后被送到我们的急诊科。病人主诉胸痛、呼吸短促，无其他主诉。患者发现右胸有一个开放性伤口，尺寸为5 x 3 cm，肺伤口底部，并有活动性出血。体格检查发现患者胸部高共振，水疱性呼吸音减少，不对称。患者被诊断为开放性气胸，进一步的指示是手术处理。该患者的胸片未见影像学异常。在这种情况下，主要的治疗方法是使用抗生素和安装胸管。病人在插入胸管后感到术后疼痛。三天后全血细胞计数显示相对正常，病人说他的抱怨在四天后减少了。两周后，病人以前的症状消失了。这种情况表明患者没有感染，这可能与抗生素的管理有关。治疗过程继续进行胸部物理治疗，直到10周后。结论:本例开放性气胸胸管术后应用抗生素治疗效果良好。需要进一步的研究来支持现有的关于开放性气胸的文献来源。
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