Friday Afternoon, May 9, 1952

2:00 P.M. Executive Session.

3:00 P.M. Scientific Session.

Address of the President, Frank B. Berry, New York, N. Y.

19. The Care of Thoracic and Thoracoabdominal Wounds in the Combat Zone in Korea.

Major Edward Ernest Rockey, M. C. (by invitation),

A.P.O., San Francisco, Calif.

A detailed report of the management of thoracic and thoracoabdominal wounds in a combat zone, based on 162 consecutive cases handled at the Mobile Army Surgical Hospital, 8076 Army Unit, between July 17, 1951 and December 17, 1951, is presented. Emphasis on the value of conservative care is made. Indications for open thoracotomy, thoracoabdominal and abdominothoracic exploration are discussed. In many thoracoabdominal wounds laparotomy and evacuation of the pleural space through the diaphragmatic tear and closure of the diaphragm from below was found to be the procedure of choice. The type of thoracic and thoracoabdominal wounds seen and the methods of treatment applied are demonstrated by illustrative case histories supplemented by charts, diagrams and X-rays. Results are tabulated.

20. War Wounds of the Chest: Experiences with 1535 Korean Casualties in an Army Hospital Overseas.

Major A. R. Valle, M. C. (by initiation), Tokyo

During the present conflict, the handling of thoracic wounds has been essentially on precepts developed during World War II. However, the availability of newer antibiotics and of SK-SD had influenced our results appreciably. These experiences will be recounted.

Nine hundred and fifty-two patients developed hemothorax; 74% of these remained sterile and 26% became infected. Sixty-eight per cent of these patients were treated by thoracentesis and antibiotics alone, recovered and returned to duty. One hundred and fifty-two decortications were performed without a death. Eighty-eight per cent of these patients were considered as having good results and returned to duty, 6.5% had fair results and returned to limited duty and 5.5% were considered to have poor results and were sent to the Zone of Interior for further treatment. Ninety-two per cent of the patients who required decortication had closed intercostal tubes inserted in Korea. In view of the fact that 79% of the patients with hemothorax recovered when treated by thoracenteses and antibiotics, we believe that thoracentesis is the best early treatment for hemothorax and that, if this conservative treatment had been carried out more frequently instead of closed thoracotomy drainage, perhaps decortication could have been avoided in some cases.

One hundred and four patients had foreign bodies removed from their chests. Seventy-three thoracotomies for removal of foreign bodies were performed. Twenty of these patients also had partial lobectomies. All recovered uneventfully and returned to duty. Thirty-one patients had foreign bodies removed at decortication. All 104 patients returned to duty.

Twenty-six patients were thoracotomized in forward areas for removal of foreign bodies. These had either fair or poor results because of increased morbidity and diminished pulmonary function. When compared with the results obtained by delayed removal, it would seem that it is best to leave the foreign body undisturbed, if possible, for later removal.

There were no operative deaths. The overall mortality was 0.4%.

6:30 P.M. Cocktail Party-Baker Hotel.