However, the lobe was not otherwise damaged, so that it could be repaired using a running suture of triple zero chromic catgut.
The anterior basal segments of the right lower lobe had a large hematoma, and blood was oozing out of one small laceration that was a little less than a centimeter in length, where a rib fragment had undoubtedly been driven into the lobe. To control hemorrhage a single suture of triple zero chromic gut was placed in this laceration. There were several small matchstick size fragments of rib within the pleural cavity. Examination, however, of the pericardium of the diaphragm and the upper lobe revealed no injury to these parts of the chest.
A drain was placed in the eighth space in the posterior axillary line similar to the drain which had been placed in the second interspace in the front of the chest.
The drain in the front of the chest was thought to be a little too long so about 3 centimeters of it were cut away.
Attention was then turned on the laceration of the latissimus dorsi muscle where the missile had passed through it. Several sutures of chromic gut where used to repair this muscle.
The incision was then closed with interrupted No. zero chromic gut in the muscles of the chest wall—first, I am sorry, in the intercostale muscle, and muscles of the chest wall, and the same suture material was used to close the serratus anterior muscle in the subcutaneous tissue, and interrupted vertical sutures of black silk were used to close the skin.
Attention was then turned to the wound of entrance which, as previously described, was about a centimeter and a half in its greatest diameter, roughly elliptical in shape. The skin edges of this wound were incised—excised, I beg your pardon—I have to go back just a little bit.
Prior to examination of this wound, a stab wound was made at the angle of the scapula to place a drain in the subscapular space. In the examination of the wound of entrance, the examining finger could determine that this drain was immediately under the wound of entrance, so that it was adequately draining the space.
Two sutures were placed in the facia of the muscle, and the skin was closed with interrupted vertical matching sutures of black silk.
That concluded the operation. Both tubes were connected to a water seal bottle, and the dressing was applied.