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European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society

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https://www.readbyqxmd.com/read/30448944/evolution-of-a-dedicated-emergency-surgery-and-trauma-esat-unit-over-3-years-sustained-improved-outcomes
#1
Si Ning Serene Goh, Woan Wui Lim, Anil Dinker Rao, Sachin Mathur, Kok Yang Tan, Tiong Thye Jerry Goo
INTRODUCTION: The traditional 24-h call model faces pressure from competing needs between emergency and elective services. Recognizing this, a dedicated ESAT service was developed in Khoo Teck Puat Hospital in Singapore, with improved clinical outcomes. It was initially led by a single consultant (SC) in 2014, and subsequently evolved to a weekly consultant rotation (WC) roster in 2017 to achieve sustainability. METHODS: Each consultant led the ESAT WC service for a week and maintained ownership of their patients thereafter...
November 17, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/30446770/etiologies-and-outcomes-of-emergency-surgery-for-acute-abdominal-pain-an-audit-of-1456-cases-in-a-single-center
#2
Yuichi Takayama, Yuji Kaneoka, Atsuyuki Maeda, Yasuyuki Fukami, Takamasa Takahashi, Masahito Uji
PURPOSE: There are few studies that have reported the details of emergency surgery for acute abdominal pain. This study aimed to clarify the etiologies and outcomes of emergency abdominal surgery among patients in different age categories. METHODS: Between January 2014 and December 2016, 1456 patients aged 7 years or older who underwent emergency surgery for acute abdominal pain at our institution were enrolled in this study. The patients were divided into three age groups: 7-17 years (n = 146), 18-64 years (n = 628), and 65 years or older (n = 682)...
November 16, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/30443777/clinical-and-radiological-short-term-outcomes-of-pubic-symphysis-diastasis-treated-with-modified-pedicle-screw-rod-fixation
#3
Jiandong Wang, Lei Cao, Jianhong Wu, Qiugen Wang, Chun Bi
PURPOSE: Pubic symphysis diastasis with an incidence of approximately 20% in pelvic fractures is a severe lesion which needs to be treated properly. The objective of this retrospective study was to describe and evaluate the clinical and radiological outcomes including its advantages and limitations of this modified minimal invasive technique. METHODS: Totally 29 patients with pubic symphysis diastasis, with or without posterior ring instability, were treated by modified pedicle screw-rod fixation (modified PSRF) between January 2010 and December 2016...
November 15, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/30406394/prehospital-triage-for-mass-casualty-incidents-using-the-meta-method-for-early-surgical-assessment-retrospective-validation-of-a-hospital-trauma-registry
#4
Rodolfo Romero Pareja, Rafael Castro Delgado, Fernando Turégano Fuentes, Israel Jhon Thissard-Vasallo, David Sanz Rosa, Pedro Arcos González
BACKGROUND: In mass casualty incidents (MCI), death usually occurs within the first few hours and thus early transfer to a trauma centre can be crucial in selected cases. However, most triage systems designed to prioritize the transfer to hospital of these patients do not assess the need for surgery, in part due to inconclusive evidence regarding the value of such an assessment. Therefore, the aim of the present study was to evaluate the capacity of a new triage system-the Prehospital Advanced Triage Method (META)-to identify victims who could benefit from urgent surgical assessment in case of MCI...
November 7, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/30392124/epidemiology-of-firearm-injuries-in-a-scandinavian-trauma-center
#5
Pernilla Brandt Bäckman, Louis Riddez, Lennart Adamsson, Carl-Magnus Wahlgren
BACKGROUND: There is a concern that civilian gunshot injuries in Europe are increasing but there is a lack of contemporary studies. The purpose of this study was to investigate the current epidemiology and outcome of firearm injuries. METHODS: Retrospective cohort study of all patients (n = 235) treated for firearm injuries admitted to a Scandinavian trauma center between 2005 and 2016. Local and national trauma registries were used for data collection. RESULTS: Mean age was 31...
November 3, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/30386866/using-cable-ties-to-connect-thoracostomy-tubes-to-drainage-devices-decreases-frequency-of-unplanned-disconnection
#6
Danielle Vanderet, Kyle Hitscherich, Patricia Philipps, Ridwan Shabsigh, Gerard A Baltazar
OBJECTIVES: Thoracostomy tube (TT) connection to drainage device (DD) may be unintentionally disconnected, potentiating complications. Tape may strengthen this connection despite minimal data informing optimal practice. Our goal was to analyze the utility of cable ties for TT to DD connection. METHODS: On April 1, 2015, our trauma center supplanted use of tape or nothing with cable ties for securing TT to DD connection. We abstracted trauma registry patients with TTs placed from March 1, 2014 to May 31, 2016 and dichotomized as prior ("BEFORE") and subsequent ("AFTER") to the cable tie practice pattern change...
November 1, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/30386865/minimally-invasive-surgical-treatment-using-iliac-pillar-screw-for-isolated-iliac-wing-fractures-in-geriatric-patients-a-new-challenge
#7
Weon-Yoo Kim, Se-Won Lee, Ki-Won Kim, Soon-Yong Kwon, Yeon-Ho Choi
PURPOSE: There have been no prior case series of isolated iliac wing fracture (IIWF) due to low-energy trauma in geriatric patients in the literature. The aim of this study was to describe the characteristics of IIWF in geriatric patients, and to present a case series of IIWF in geriatric patients who underwent our minimally invasive screw fixation technique named 'iliac pillar screw fixation'. MATERIALS AND METHODS: We retrospectively reviewed six geriatric patients over 65  years old who had isolated iliac wing fracture treated with minimally invasive screw fixation technique between January 2006 and April 2016...
November 1, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/30382316/no-correlation-between-lower-extremity-deep-vein-thrombosis-and-pulmonary-embolism-proportions-in-trauma-a-systematic-literature-review
#8
REVIEW
Hiba Abdel Aziz, Barbara M Hileman, Elisha A Chance
PURPOSE: To assess the effect of surveillance on deep vein thrombosis (DVT) and pulmonary embolism (PE) rates, the efficacy of chemoprophylaxis and mechanical prophylaxis, and the relationship between DVT and PE. METHODS: A 23 year, systematic literature review was performed in PubMed. Twenty publications with > 13,000 patients were reviewed. Analyzed traits included: DVT surveillance utilization, the total number of patients included in each study, the number of patients developing DVT and/or PE, chemoprophylaxis and mechanical prophylaxis utilization...
November 1, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/30382315/external-fixation-of-segmental-tibial-shaft-fractures
#9
Sasa Milenkovic, Milan Mitkovic, Milorad Mitkovic
PURPOSE: Tibial shaft fractures are the most common type of large long-bone fractures. Segmental tibial shaft fractures are severe injuries and its treatment can be followed by a high incidence of complications, nonunion, delayed union, malunion, infection or compartment syndrome. The most common treatment strategy is intramedullary fixation. Results of the unilateral external fixation treatment for segmental tibial shaft injuries are presented in this paper. METHODS: Patients with segmental tibial shaft fractures, AO/OTA 42-C2 were treated as urgent cases by unilateral external fixation...
October 31, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/30382314/radial-head-arthroplasty-for-radial-head-fractures-a-clinical-and-radiological-comparison-of-monopolar-and-bipolar-radial-head-arthroplasty-at-a-mean-follow-up-of-6-years
#10
Sebastian Mukka, Pontus Sjöholm, Nikolaos Perisynakis, Per Wahlström, Hans Rahme, Bakir Kadum
PURPOSE: The purpose of this study was to compare clinical and radiographic outcomes of bipolar and monopolar radial head arthroplasty in treatment of radial head fracture at a mean follow-up of 6 years. METHODS: A retrospective multicentre cohort study of 30 patients treated for unreconstructable radial head fractures. Patients were treated either with a cemented bipolar or an uncemented monopolar radial head arthroplasty. All patients included were evaluated with patient-rated outcome questionnaire, physical examination, and radiographic evaluation at a mean of 6 years (range, 2-12 years) postoperatively...
October 31, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/30367181/readmission-after-antibiotic-management-of-uncomplicated-acute-appendicitis-in-adults-prospective-study
#11
Abdulrahman Saleh Al-Mulhim
BACKGROUND: Acute appendicitis is the most common surgical cause of acute abdomen. Many randomized studies compare between antibiotic and surgery, and such studies indicated that antibiotics might treat acute appendicitis. However, there are concerns about selection bias in previous studies. Hence, to overcome this worry; we used in this study a full-scale population-based application. PATIENTS AND METHODS: We identified 327 adult patients who were admitted to surgical ward with diagnosis of uncomplicated acute appendicitis between March 2013 and February 2016...
October 26, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/30350005/comparison-of-intraoperative-2d-vs-3d-imaging-in-open-reduction-and-fixation-of-distal-radius-fractures
#12
Diego Hammerle, Georg Osterhoff, Florin Allemann, Clement Max Léonard Werner
PURPOSE: In the volar plating of distal radius fractures, intraoperative three-dimensional (3D) imaging is designed to allow better judgment regarding screw and implant positioning compared with conventional intraoperative two-dimensional (2D) imaging. We evaluated the impact of these two imaging modalities on the rates of intraoperative revision and secondary surgery, as well as the need for implant removal during follow-up. METHODS: A retrospective analysis of consecutive patients who underwent volar plate osteosynthesis for isolated distal radius fractures between January 2008 and April 2016 was performed...
October 22, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/30350004/are-injury-admissions-on-weekends-and-weeknights-different-from-weekday-admissions
#13
Abebe Tiruneh, Maya Siman-Tov, Irina Radomislensky, Kobi Peleg
PURPOSE: To examine whether hours of a day and days of a week influence injury pattern, means of evacuation, and hospital resource utilization. METHODS: A study based on the Israeli National Trauma Registry of patients hospitalized due to injury between 2008 and 2015. RESULTS: Of 293,077 subjects included; 32.8% were admitted on weekends (weekend-days 16.7% and weekend-nights 16.1%), 20.0% on weeknights and 47.2% on weekdays. Compared with weekday admissions, weekend and weeknight admissions had higher risk of hospitalization from violence and fall-related injuries, but lower risk from road traffic injuries (RTI) except for weekend-day admissions adjusted for age, gender, and ethnicity...
October 22, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/30341561/rib-fixation-versus-non-operative-treatment-for-flail-chest-and-multiple-rib-fractures-after-blunt-thoracic-trauma-a-multicenter-cohort-study
#14
Reinier B Beks, David Reetz, Mirjam B de Jong, Rolf H H Groenwold, Falco Hietbrink, Michael J R Edwards, Luke P H Leenen, Roderick Marijn Houwert, Jan Paul M Frölke
BACKGROUND: Over the years, a trend has evolved towards operative treatment of flail chest although evidence is limited. Furthermore, little is known about operative treatment for patients with multiple rib fractures without a flail chest. The aim of this study was to compare rib fixation based on a clinical treatment algorithm with nonoperative treatment for both patients with a flail chest or multiple rib fractures. METHODS: All patients with ≥ 3 rib fractures admitted to one of the two contributing hospitals between January 2014 and January 2017 were retrospectively included in this multicenter cohort study...
October 19, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/30327836/the-implementation-of-a-clinical-pathway-enhancing-early-surgery-for-geriatric-hip-fractures-how-to-maintain-a-success-story
#15
An Sermon, Ine Rochus, Bart Smeets, Willem-Jan Metsemakers, Dominique Misselyn, Stefaan Nijs, Harm Hoekstra
BACKGROUND: Timing of surgery in geriatric hip fracture treatment remains controversial. Early surgery is acknowledged as a quality indicator and NICE guidelines recommend surgery within 0-48 h from admission. In 2014 we implemented the indicator of early surgery in our institution, enhancing operative treatment within the next calendar day. We aimed to evaluate the implementation, define the room for improvement and provide strategies to maintain the quality indicator. METHODS: Clinical outcome of 744 patients (January 2011-December 2013) before early surgery was implemented, compared to 817 patients (June 2014-May 2017) after implementation of early surgery with a follow-up of 6 months...
October 16, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/30324241/the-need-for-red-blood-cell-transfusions-in-the-emergency-department-as-a-risk-factor-for-failure-of-non-operative-management-of-splenic-trauma-a-multicenter-prospective-study
#16
Paola Fugazzola, Lucia Morganti, Federico Coccolini, Stefano Magnone, Giulia Montori, Marco Ceresoli, Matteo Tomasoni, Dario Piazzalunga, Stefano Maccatrozzo, Niccolò Allievi, Savino Occhionorelli, Luca Ansaloni
INTRODUCTION: The majority of patients with splenic trauma undergo non-operative management (NOM); around 15% of these cases fail NOM and require surgery. The aim of the current study is to assess whether the hemodynamic status of the patient represents a risk factor for failure of NOM (fNOM) and if this may be considered a relevant factor in the decision-making process, especially in Centers where AE (angioembolization), intensive monitoring and 24-h-operating room are not available...
October 15, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/30324240/injuries-related-to-bicycle-accidents-an-epidemiological-study-in-the-netherlands
#17
Livia E V M de Guerre, Said Sadiqi, Loek P H Leenen, Cumhur F Oner, Steven M van Gaalen
BACKGROUND: This study aims to analyze the incidence and outcomes of bicycle-related injuries in hospitalized patients in The Netherlands. METHODS: Bicycle accidents resulting in hospitalization in a level-I trauma center in The Netherlands between 2007 and 2017 were retrospectively identified. We subcategorized data of patients involved in a regular bicycle, race bike, off-road bike or e-bike accident. The primary outcomes were mortality rate and incidence of multitrauma...
October 15, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/30324239/optic-nerve-sheath-diameter-on-facial-ct-a-tool-to-predict-traumatic-brain-injury
#18
Sun Hwa Lee, Seong Jong Yun
PURPOSE: To evaluate and compare the optic nerve sheath diameters (ONSDs) of facial trauma patients as observed on facial CT and brain CT, and to evaluate the predictive performance of ONSD as seen on facial CT for traumatic brain injury (TBI). METHODS: We retrospectively enrolled 262 patients with facial trauma who underwent both facial CT and brain CT. Two reviewers independently measured ONSD at 3 mm (ONSD3) and 10 mm behind the globe (ONSD10) for each patient on both CT scans...
October 15, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/30324238/higher-age-is-a-major-driver-of-in-hospital-adverse-events-independent-of-comorbid-diseases-among-patients-with-isolated-mild-traumatic-brain-injury
#19
Barbara R Schmidt, Rudolf M Moos, Dilek Könü-Leblebicioglu, Heike A Bischoff-Ferrari, Hans-Peter Simmen, Hans-Christoph Pape, Valentin Neuhaus
PURPOSE: The goal of this study was to investigate if and to what extent age, independent of comorbid diseases, is a risk factor for negative in-hospital outcome with mTBI. METHODS: In a retrospective cohort study, we identified 1589 adult patients treated for isolated mTBI in our level-1 trauma center between 2008 and 2015. We used logistic regression analyses to assess the odds of any adverse event by age group (< 65, 65-75, 76-85, and 85+), adjusting for gender and chronic diseases...
October 15, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/30317378/trauma-center-need-the-american-college-of-surgeons-definition-in-contrast-to-swiss-highly-specialized-medicine-regulations-a-swiss-trauma-center-perspective
#20
Thomas Gross, Philipp Braken, Felix Amsler
PURPOSE: According to the American College of Surgeons (ACS) recommendations, the benchmark for trauma center need (TCN) is an Injury Severity Score (ISS) > 15. In contrast, Swiss highly specialized medicine (HSM) regulations set out TCN for all patients with an ISS > 19 or an Abbreviated Injury Severity (AIS) of the head ≥ 3. This investigation assessed to what extent the modification might be justified. METHODS: Consecutive analysis of all significantly injured (new ISS, NISS ≥ 8) adults treated in a trauma center from 2010 to 2016 based on their ISS and AIS head and in respect to utilized resources and outcome...
October 13, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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