| BackgroundIn modern wartimes, the number of thoracic wound soldiers account for 7-12% insum total. Thoracic trauma(TT) is often severe and its mortality rate(MR) is higher than other trauma.The death in battlefield caused directly by thoracic trauma is 25% or so. It is reported that in normal time, the incidence rate(IR) and mortality rate (MR) is similar to that in wartime. So thoracic trauma(TT) possesses very important positiong in modern trauma no matter in peacetime or in wartime. TT on battlefield is firearm wounded in majority. The IR of traumatic hemopneumothorax(TH) reached up to 97.6%. TH needed first aid in most instances.If it was treated improperly or not in time, it would lead to or sharpen wounded soldiers' physiologic function disorder of important organ, such as respiration and circulation. It is one of the principal cause of death(COD) in the initial stage of TT.Chief therapeutic operation of TH is close drainage of thoracic cavity(CDTC). In former wars, TCD was operated in hospital at front line of battlefield, and some soldiers of macrotrauma died in battlefield or on the way of conveying for non-remeding in time. At first aid of TT formerly, once we utilized urinary drainage tube, latex tubing, exhaust pipe for passage of gas by anus as intrathoracic drain tube(ITDT), because of the confinement medical condition on battlefield. Because the lumens is too small for drainage, it is easy to block up and cannot reach the purpose of drainage. The transportation of wounded soldiers who carried water-sealed drainage bottle was extremely formidable in wartimes, so it was often clamping the drainage tube when transporting wounded soldier. How to maintain effectual drainage on transporting is always look forward to solve. At war in present age,the incidence rate (IR) and severity of TT is increasing and the salvage at scene require furthermore emphasizing.Because of its bigger volume and weight, the nowadays' intrathoracic drain tube commonly used in clinical is not suitable for emergency treatment on battlefield(ETOB). For this reason, we newly designed and manufactured a sort of intrathoracic drain tube and a sort of portable first aid package for traumatic hemopneumothorax on battlefield so as to easy to conveying and transporting of thoracic wounded soldier in wartime. Simultaneously, we also hope it is applicable for pre-hospital care of severe thoracic trauma(TT) in peacetime.ObjectiveThis empirical study aim at:1. To design and manufacture a sort of portable first aid package for traumatic hemopneumothorax on battlefield.2. To establish a simple hemopneumothorax animal model and an open pneumothorax animal model, and to operate closed drainage of thoracic cavity with it,to validate or assess its manipuility, effectiveness of drainage, douching of pectoral cavity, and so on.3. Used in preliminary clinic application to observe and evaluate its feasibility and effectiveness.Materials and Methods1. To design and manufacture the portable first aid package for traumatic hemopneumothorax on battlefield. It consist of a multifunctional drainage tube, folded drainage pack, and other appendixes. The multifunctional drainage tube includes guide pin for thoracentesis, air bladder for fixing and douche tube for thoracic cavity.2. Infuse blood and gas into experimental animal thoracic cavity to establish the animal model of simple hemopneumothorax.3. The experimental animal were randomly divided into 2 groups which were control group(n=4) and experimental group(n=8). The control group disposaled by closed drainage with normal drainage tube and surgical instrument which is often applying in clinic, while the experimental group was dealed with the first aid packagewe designed. Contrast the operation time, the volume of drainage, and the tensile strength which the tube can endured when it fixed in chest wall of the 2 groups. And evaluate the flushing effect and hemostasis effect of the experimental group.4. Apply the portable first aid package in clinic to observe and evaluate its feasibility and effectiveness.Results1. The experimental group's operation time is (5.5±1.2) min.The control group's operation time is(12±2.3)min. The experimental group's operation time is significantly shorter than the control group's(P<0.01).2. The drainaged volume of 30min, lh, 2h, 4h, 6h after operation of the control group is (113±12), (258±22), (441±28), (572±33), (623±52)ml, the volume of the experimental group is (126±17), (242±24), (462±32), (590±42), (632±37)ml, and there is no difference in 2 groups (P>0.05) .3. The tensile strength which the control group can endured is(5±0.5)kg, while the experimental group is more than (8±0.7) kg, there is significant difference in 2 groups(PO.Ol).4. The control group's irrigation equipment of drainage tube may dribble liquid at maximal speed (670±30)ml/h. The experimental group's irrigation equipment of drainage tube may dribble liquid at maximal speed (700±20)ml/h, there is no difference in 2 groups (P>0.05) .5. The air pocket internal which fixed on the tube of the control group has hemostasis effect when the infra-rib blood vessel are broken.6. In clinic application, the new portable first aid package for traumatic hemopneumothorax is no different with common thoracic close drainage system in clinic in effectiveness.ConclusionsThe portable first aid package for traumatic hemopneumothorax is not evident difference in drainage effect at the emergency treatment for hemopneumothoraxcontrasting with normal closed drainage instrument applying in clinic now. But it has minor volum and preferable portability, and may avoid fixing with stitch, and irrigate the thoracic cavity, as well as has hemostasis effect on the broken infra-rib blood vessel. It is convenient in clinical application, and has certain effectiveness. It is well-suited for salvage at scene of thoracic wound in field battle, and also fit for pre-hospital care of thoracic trauma in peacetime.
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