Figure 2

Status of patient's wounds upon return to the operating room after 24 hours of open-chest management. The development of thoracic compartment syndrome necessitated therapeutic re-opening of the chest and open-chest management. A) Open trap-door thoracotomy. Comprised of connecting anterolateral thoracotomy in the 6^th intercostal space, partial sternotomy, and supraclavicular incisions. The reflection edge for the trap-door is shown by the black hatched lines: the ribs along this edge were fractured by the reflection of the trap-door. B) Open midline laparotomy with Bogota bag sewn onto the skin.