Autotransfusion in penetrating chest war trauma with haemothorax: The Keysaney Hospital experience

Abstract

Background: In 1991 civil war broke out in Somalia and Mogadishu was divided into two areas, occupied by different clans. No hospital facility was available in  Mogadishu North to take care of the war wounded. The International Committee of the Red Cross (ICRC), together with the Somalia Red Crescent Society found a new building, 7 km North of the town, intended to be a prison: Keysaney Hospital was thus inaugurated in February 1992. It was soon established as The War Surgery Hospital in Somalia.
Methods: This was a retrospective study. From 1992 to 2001,45,900 war-wounded patients were admitted and treated; among whom 13770 had chest injuries. Due to lack of a blood bank, insufficient number of donors, continuous need in emergency, life threatening situations and following previous positive experiences, a system was set up for immediate auto transfusion in patients with massive haemothorax from penetrating chest war wounds. To reduce the risk of the 2 major complications of sepsis and coagulopathy, each patient received antibiotic prophylaxis and only cases with a maximum delay of one hour were subjected to this form of management.
Results: 137 patients had this kind of auto transfusion. There were five deaths (3.6% Mortality rate) No major complications were detected in the auto-transfused patients that survived.

Key words: Auto transfusion, penetrating, chest, war wounds and haemothorax.