The treatment of stabbed chests at Ngwelezana hospital, KwaZulu - Natal

Abstract

A study was undertaken at Ngwelezana hospital to determine the requirements for a cost effective physiotherapy service for patients with stabbed chests. Forty male patients between the ages of 16 and 60 who had sustained unilateral penetrating stab wounds to the chest which required intercostal drainage were randomised into one of two groups on admission to Ngwelezana hospital.
The patients in group I received physiotherapy immediately after insertion of the intercostal drain, while the patients in group 2 received physiotherapy 12 to 24 hours after insertion of the drain. Mean duration of intercostal drainage in group I was 2.35 days while that of group 2 was 7.55 days. This represented a significantly shorter drainage time for the patients who had been treated immediately after insertion of the drain. Patients were discharged from hospital on the day that the intercostal drain was removed. No complications were experienced by the patients in group 1 while four patients in group 2 developed an empyema.
The cost of the patients in group 2 exceeded the costs of those in group 1 by R78 728.00. It is thus imperative that patients admitted with stabbed chests should have physiotherapy immediately after insertion of the intercostal drain.