To avoid collapse of lungs upon closure of a thoracotomy, the surgeon’s primary concern should be?

VSR-0001

QUESTION

To avoid collapse of lungs upon closure of a thoracotomy, the surgeon’s primary concern should be?

OPTIONS

(A) Suturing the intercostal muscles adequately
(B) Suturing the lateral thoracic musculature adequately
(C) Making sure that the lung is moist before closure
(D) Creating negative pressure in the pleural cavity

ANSWER

(D) Creating negative pressure in the pleural cavity

EXPLANATION

Air entering the pleural cavity during thoracotomy abolishes the pressure difference that keeps the lungs expanded. Evacuating that air and restoring negative pleural pressure before final closure lets the lungs re-expand; secure muscle closure maintains the seal, whereas wetting the lung or merely suturing individual muscle layers does not itself restore the pressure.

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