History of surgery for penetrating chest trauma.

The military surgery experience of the past several centuries has been an important determinant of the evolution of the clinical management of penetrating thoracic trauma. The major management problems fall into two main categories: acute, life-threatening conditions such as open pneumothorax and exsanguinating hemorrhage, and chronic conditions such as clotted hemothorax, empyema, and fibrothorax. Better treatment and prevention of the latter has greatly reduced morbidity. Although hospital mortality has fallen by a factor of ten since the middle of the nineteenth century, the total mortality caused by penetrating thoracic trauma has undergone less change.