生体吸収性プレートにより外固定を行ったフレイルチェスト

Fixation of Flail Chest with Bioabsorbable Plate

フレイルチェストに対する外固定では骨接合材として金属プレートを用いることが多いが，術後感染を危惧する場合は使用がためらわれる．われわれは，ダメージコントロール手術で胸腔内ガーゼパッキングを行った後のフレイルチェストに対し，生体吸収性プレートを用いて外固定を行い良好な臨床経過を得た1例を経験したので報告する．

A 57-year-old man presented to our hospital with multiple rib fractures and pleural effusion caused by a traffic accident. We inserted a chest tube and diagnosed him with hemothorax. We performed damage control surgery with right thoracotomy in the emergency room to confirm the bleeding point. The main sources of bleeding were multiple rib fractures and lung injury. We performed partial lung resection and gauze packing into the thoracic cavity and confirmed the stability of the patient’s hemodynamics. The next day, we performed a second-look operation at which we fixed the rib fractures and confirmed hemostasis. When fixing the ribs, we used a bioabsorbable plate instead of a metal plate. It has been reported that bioabsorbable plates are less susceptible to infection than metal plates. After the operation, the patient’s respiratory condition stabilized, and no signs of infection were noted. In our experience, rib fixation using absorbent plates is useful in surgery that requires attention to infection.