Flail chest surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Surgery

Treatment of the flail chest initially follows the principles of Advanced Trauma Life Support. Further treatment includes:

• Good analgesia including intercostal blocks, avoiding narcotic analgesics as much as possible. This allows much better ventilation, with improved tidal volume, and increased blood oxygenation.
• Positive ventilation, meticulosly adjusting the ventilator settings to avoid barotrauma.
• Chest tubes as required.
• Adjustment of position to make the patient most comfortable and provide relief of pain.

Surgical fixation is usually not required.