Which chest injury is defined by air entering through the chest wound with each inhalation and can be aggravated by an occlusive dressing sealed on three sides?

• A. Flail segment
• B. Sucking chest wound
• C. Open pneumothorax
• D. Pulmonary contusion

Answer: (B)

Air is drawn into the chest through a wound with every breath—that hallmark sound and flow defines a sucking chest wound. This penetrating chest injury creates a communication between the outside environment and the pleural space, so inhalation pulls air through the wound and into the chest, often accompanied by a distinctive sucking sound. An occlusive dressing sealed on three sides can worsen the situation because it can trap air in the chest rather than vent it, increasing intrapleural pressure and the risk of a growing pneumothorax or even tension pneumothorax. The other injuries describe different chest problems: a flail segment involves paradoxical chest wall movement rather than an air leak through a wound; an open pneumothorax also involves a chest wound, but the defining feature here is the sustained sucking air through the wound; a pulmonary contusion is bruising of lung tissue with no direct air leak through the chest wall.