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Surgical Clinics of North America

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https://www.readbyqxmd.com/read/28958371/preface
#1
EDITORIAL
Oscar D Guillamondegui, Bradley M Dennis
No abstract text is available yet for this article.
October 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28958370/trauma-2017
#2
EDITORIAL
Ronald F Martin
No abstract text is available yet for this article.
October 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28958369/balanced-resuscitation-in-trauma-management
#3
REVIEW
Paul M Cantle, Bryan A Cotton
Over the past decade substantial knowledge has been gained in understanding both the coagulopathy of trauma and the complications associated with aggressive crystalloid-based resuscitation. Balanced resuscitation, which includes permissive hypotension, limiting crystalloid use, and the transfusion of blood products in ratios similar to whole blood, has changed the previous standard of care. Prompt initiation of massive transfusion and the protocolled use of 1:1:1 product ratios have improved the morbidity and mortality of patients with trauma in hemorrhagic shock...
October 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28958368/assessment-and-resuscitation-in-trauma-management
#4
REVIEW
Stephen Gondek, Mary E Schroeder, Babak Sarani
The golden hour of trauma represents a crucial period in the management of acute injury. In an efficient trauma resuscitation, the primary survey is viewed as more than simple ABCs with multiple processes running in parallel. Resuscitation efforts should be goal oriented with defined endpoints for airway management, access, and hemodynamic parameters. In tandem with resuscitation, early identification of life-threatening injuries is critical for determining the disposition of patients when they leave the trauma bay...
October 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28958367/prehospital-assessment-of-trauma
#5
REVIEW
Joshua Brown, Nitin Sajankila, Jeffrey A Claridge
The organization of prehospital care for trauma patients began in the military arena. At the urging of multiple stakeholders and providers, these lessons were applied to the civilian setting and emergency medical services were created across the nation. Advances have taken place in the triage, transport, and management of severely injured patients. Many issues remain in the care of trauma patients in the prehospital environment. Collaboration between stakeholders and providers, regionalization of trauma care, and protocol-driven care may be solutions to some of these issues...
October 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28958366/trauma-systems-origins-evolution-and-current-challenges
#6
REVIEW
Danielle A Pigneri, Brian Beldowicz, Gregory J Jurkovich
Trauma is the leading cause of death among patients 46 years or younger, and having a system in place for the care of the injured is of paramount importance to the health of a community. The growth and development of civilian trauma systems has not been an easy process. The concept of regionalized health care that the trauma system models has been emulated by other specialized and time-sensitive areas of medicine, notably stroke and acute cardiac events. Continued process improvement, public education, support and involvement, a sound infrastructure, and integrated technology should remain our focus...
October 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28958365/trauma-education-and-prevention
#7
REVIEW
Richard Sidwell, Maher M Matar, Joseph V Sakran
Trauma education and injury prevention are essential components of a robust trauma program. Educational programs address specific knowledge gaps and provide focused and structured learning. Advanced Trauma Life Support is the most well-known. Each offering seems to be valid, although it has been difficult to prove improved patient care outcomes owing specifically to any of them. Injury prevention offers the best opportunity to limit death and disability owing to trauma. Injury prevention initiatives have paid tremendous dividends in reducing the mortality rates for motor vehicle crashes...
October 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28958364/radiology-for-trauma-and-the-general-surgeon
#8
REVIEW
Patrick K Kim
Conventional radiography (plain film), ultrasonography, and computed tomography (CT) are important modalities for the evaluation of patients with trauma. In meta-stable or unstable patients, the combination of chest radiograph, pelvis radiograph, and focused assessment for sonography in trauma (FAST) or extended FAST rapidly triages the torso. CT has become a standard for definitive imaging in blunt trauma. CT angiography is the modality of choice for suspected vascular injuries of the neck and extremities...
October 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28958363/evidence-based-care-of-geriatric-trauma-patients
#9
REVIEW
Steven E Brooks, Allan B Peetz
The doubling of the geriatric population over the next 20 years will challenge the existing health care system. Optimal care of geriatric trauma patients will be of paramount importance to the health care discussion in America. These patients warrant special consideration because of altered anatomy, physiology, and the resultant decreased ability to tolerate the stresses imposed by traumatic insult. Despite increased risk for worsened outcomes, nearly half of all geriatric trauma patients will be cared for at nondesignated trauma centers...
October 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28958362/surgical-management-of-vascular-trauma
#10
REVIEW
Pedro G R Teixeira, Joe DuBose
Vascular injuries remain among the most challenging entities encountered in trauma care. Improvements in diagnostic capabilities, resuscitation approaches, vascular techniques, and prosthetic device options have afforded considerable advancement in the care of these patients. This evolution in care capabilities continues. Despite advances, uncontrolled hemorrhage due to major vascular injury remains one of the most common causes of death after trauma. Successful management of vascular injury requires the timely diagnosis and control of bleeding sources; to facilitate this task, trauma providers must appreciate the capabilities and limitations of diagnostic imaging modalities...
October 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28958361/surgical-management-of-musculoskeletal-trauma
#11
REVIEW
Daniel J Stinner, Dafydd Edwards
Musculoskeletal injuries cause a significant burden to society and can have a considerable impact on patient morbidity and mortality. It was initially thought that these patients were too sick to undergo surgery and later believed that they were too sick not to undergo surgery. The pendulum has subsequently swung back and forth between damage control orthopedics and early total care for polytrauma patients with extremity injuries and has settled on providing early appropriate care (EAC). The decision-making process in providing EAC is reviewed in an effort to optimize patient outcomes following severe extremity trauma...
October 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28958360/surgical-management-of-abdominal-trauma-hollow-viscus-injury
#12
REVIEW
Jamie J Coleman, Ben L Zarzaur
Hollow viscus injury is common with penetrating trauma to the torso and infrequent with a blunt traumatic mechanism of injury. The diagnosis in hemodynamically unstable patients is often made in the operating room. In hemodynamically stable patients, the diagnosis can be difficult due to additional injuries. Although computed tomography remains the diagnostic tool of choice in hemodynamically stable patients, it has lower reported sensitivity and specificity with hollow viscus injury. However, even short delays in diagnosis increase morbidity and mortality significantly...
October 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28958359/surgical-management-of-solid-organ-injuries
#13
REVIEW
Niels V Johnsen, Richard D Betzold, Oscar D Guillamondegui, Bradley M Dennis, Nicole A Stassen, Indermeet Bhullar, Joseph A Ibrahim
Surgery used to be the treatment of choice in patients with solid organ injuries. This has changed over the past 2 decades secondary to advances in noninvasive diagnostic techniques, increased availability of less invasive procedures, and a better understanding of the natural history of solid organ injuries. Now, nonoperative management (NOM) has become the initial management strategy used for most solid organ injuries. Even though NOM has become the standard of care in patients with solid organ injuries in most trauma centers, surgeons should not hesitate to operate on a patient to control life-threatening hemorrhage...
October 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28958358/blunt-and-penetrating-cardiac-trauma
#14
REVIEW
Seth A Bellister, Bradley M Dennis, Oscar D Guillamondegui
Patients with traumatic cardiac injuries can present with wide variability in their severity of illness. The most severe will present in cardiac arrest, whereas the most benign may be altogether asymptomatic; most will fall somewhere in between. Management of cardiac injuries largely depends on mechanism of injury and patient physiology. Understanding the spectrum of injuries and their associated manifestations can help providers react more quickly and initiate potentially life-saving therapies more efficiently when time is critical...
October 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28958357/thoracic-trauma
#15
REVIEW
Bradley M Dennis, Seth A Bellister, Oscar D Guillamondegui
Management of chest trauma is integral to patient outcomes owing to the vital structures held within the thoracic cavity. Understanding traumatic chest injuries and appropriate management plays a pivotal role in the overall well-being of both blunt and penetrating trauma patients. Whether the injury includes rib fractures, associated pulmonary injuries, or tracheobronchial tree injuries, every facet of management may impact the short- and long-term outcomes, including mortality. This article elucidates the workup and management of the thoracic cage, pulmonary and tracheobronchial injuries...
October 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28958356/trauma-spinal-cord-injury
#16
REVIEW
Matthew J Eckert, Matthew J Martin
Injuries to the spinal column and spinal cord frequently occur after high-energy mechanisms of injury, or with lower-energy mechanisms, in select patient populations like the elderly. A focused yet complete neurologic examination during the initial evaluation will guide subsequent diagnostic procedures and early supportive measures to help prevent further injury. For patients with injury to bone and/or ligaments, the initial focus should be spinal immobilization and prevention of inducing injury to the spinal cord...
October 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28958355/acute-management-of-traumatic-brain-injury
#17
REVIEW
Michael A Vella, Marie L Crandall, Mayur B Patel
Traumatic brain injury (TBI) is a leading cause of death and disability in patients with trauma. Management strategies must focus on preventing secondary injury by avoiding hypotension and hypoxia and maintaining appropriate cerebral perfusion pressure (CPP), which is a surrogate for cerebral blood flow. CPP can be maintained by increasing mean arterial pressure, decreasing intracranial pressure, or both. The goal should be euvolemia and avoidance of hypotension. Other factors that deserve important consideration in the acute management of patients with TBI are venous thromboembolism, stress ulcer, and seizure prophylaxis, as well as nutritional and metabolic optimization...
October 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28728725/preface
#18
EDITORIAL
John H Braxton
No abstract text is available yet for this article.
August 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28728724/foreword
#19
EDITORIAL
Ronald F Martin
No abstract text is available yet for this article.
August 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28728723/surgical-treatment-of-heart-failure
#20
REVIEW
Robert S D Higgins, Ahmet Kilic, Daniel G Tang
More than 5 million Americans suffer from heart failure and more than 250,000 die annually. Cardiac surgery, as applied to advanced heart failure, has evolved significantly in the past 50 years. Current therapeutic interventions are focused on the appropriate assessment of myocardial dysfunction as a means to select the right patient for the appropriate procedure using state-of-the-art myocardial viability testing and metabolic testing to determine candidacy for conventional interventions, mechanical devices, or transplant...
August 2017: Surgical Clinics of North America
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