Background and objectives: Nowadays, the areas for
insertion of tube thoracostomy are mostly applied in
the safety triangle area (lateral border of pectoralis
major muscle, anterior border of latissimus dorsi
muscle and the nipple line). The thicker chest wall
may contribute to difficult tube thoracostomy
insertion. So, cadaveric chest walls are measured for
thickness to confirm appropriateness of safety triangle.
Methods: The fresh cadaveric chest wall was
measured by the needle tapping the chest wall
within the safety triangle combined with sternotomy
to determine the thinnest area of the chest wall. The
measured values are recorded in millimeters (mm.).
The mean thickness of the chest wall, standard
deviation (SD), BMI of the cadaver before preparation
were studied
Results: The 20 fresh cadaveric chest walls were
measured for thickness. The mean chest wall thickness
within the safety triangle varies between 14.4 mm. to
23.9 mm. The areas with more than 50 mm thickness
were mostly found in the mid-axillary line and two
cases (54 and 56 mm.) in the 3rd intercostal space
crossing with anterior axillary line. While the thinnest
areas (14.4 mm.) are found within 7th intercostal space.
Most female cadavers have thicker chest wall than
male.
Conclusion: Some areas in the safety triangle for tube
thoracostomy insertion are more than 50 mm. in
thickness. The area for insertion of the tube
thoracostomy should be carefully selected,especially in woman and the obese patients.
Moreover, insertion below 6th intercostal space should
be avoided due to risk of peritoneal penetration.