Almost all historical accounts of chest trauma are within the context of war and conflict. The oldest surgical treatise on record is the Edwin Smith Surgical Papyrus from around 3000 BC, which predates Hippocrates by approxi- mately 1000 years and is believed to have been a handbook for the treatment of injuries sustained during military campaigns. However, few if any of these ancient writings effectively address intrathoracic injuries, as they mainly deal with extremity and soft-tissue wounds. Hemothorax and pneumothorax were first described about 200 years ago, and evacuation by either incisional drainage or tube placement was standard practice by the 1870s, with the development of underwater-seal drainage devices coming not long after. Ludwig Rehn described the first cardiorrhaphy for a penetrating injury in 1896. However, most of the major operations that will be described in this chapter have been innovations of the twentieth century, with guidelines for the management of penetrating thoracic trauma not established until World War II.
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