Modified application of a wound retractor for surgery in chest trauma.

Wound retraction is useful for chest wall surgery involving surgical rib fixation in patients with rib fractures. However, blunt chest trauma with rib fractures frequently involves lung injury, requiring simultaneous pulmonary repairs. In intrapleural surgery for chest trauma involving rib fractures, a rib spreader could cause additional rib fractures. Therefore, we describe the modified application of a second wound retractor for surgery in the thorax and chest wall, and discuss its advantages and disadvantages. We call this method double-wound retraction.