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Acute lacerations

Kashif Rahim, Shamim Saleha, Xudong Zhu, Liang Huo, Abdul Basit, Octavio Luiz Franco
A wound is damage of a tissue usually caused by laceration of a membrane, generally the skin. Wound healing is accomplished in three stages in healthy individuals, including inflammatory, proliferative, and remodeling stages. Healing of wounds normally starts from the inflammatory phase and ends up in the remodeling phase, but chronic wounds remain in an inflammatory stage and do not show progression due to some specific reasons. Chronic wounds are classified in different categories, such as diabetic foot ulcer (DFU), venous leg ulcers (VLU) and pressure ulcer (PU), surgical site infection (SSI), abscess, or trauma ulcers...
October 14, 2016: Microbial Ecology
A Larcher, M Sun, P Dell'Oglio, V Trudeau, K Boehm, J Schiffmann, Z Tian, N Fossati, U Capitanio, A Briganti, F Montorsi, P Karakiewicz
BACKGROUND: Local tumour ablation (LTA) may yield better perioperative outcomes than partial nephrectomy (PN), however the impact of each treatment on perioperative mortality and health care expenditures is unknown. The aim of the study was to compare mortality, morbidity and health care expenditures between LTA and PN. PATIENTS AND METHODS: A population-based assessment of 2471 patients with cT1a kidney cancer treated with either LTA or PN, between 2000 and 2009, in the SEER-Medicare database was performed...
September 17, 2016: European Journal of Surgical Oncology
B Tettenborn, S Mehnert, I Reuter
Peripheral nerve injuries due to sports are relatively rare but the exact incidence is not known due to a lack of epidemiological studies. Particular sports activities tend to cause certain peripheral nerve injuries including direct acute compression or stretching, repetitive compression and stretching over time, or another mechanism such as ischemia or laceration. These nerve lesions may be severe and delay or preclude the athlete's return to sports, especially in cases with delayed diagnosis. Repetitive and vigorous use or overuse makes the athlete vulnerable to disorders of the peripheral nerves, and sports equipment may cause compression of the nerves...
September 2016: Fortschritte der Neurologie-Psychiatrie
Gianfranco Donatelli, Fabrizio Cereatti, Parag Dhumane, Bertrand Marie Vergeau, Thierry Tuszynski, Christian Marie, Jean-Loup Dumont, Bruno Meduri
BACKGROUND: The Over-The-Scope Clip (OTSC®, Ovesco Endoscopy GmbH, Tübingen, Germany) is an innovative clipping device that provides a strong tissue grasp and compression without provoking ischemia or laceration. In this retrospective study we evaluated immediate and long-term success rates of OTSC deployment in various pathologies of the gastrointestinal (GI) tract. METHODS: A total of 45 patients (35 female, 10 male) with an average age of 56 years old (range, 24-90 years) were treated with an OTSC for GI defects resulting from a diagnostic or interventional endoscopic procedure (acute setting group) or for fistula following abdominal surgery (chronic setting group)...
September 2016: Therapeutic Advances in Gastroenterology
Marianna Russo, Melissa Rosa-Rizzotto, Mariarosa Giolito, Cristina Ranzato, Paola Facchin, Anna Aprile
Child victims of sexual abuse may present with physical findings whose interpretation requires the most exhaustive evaluation and an accurate collection of a detailed history. Genital bleeding is usually considered as an acute sign, related to a trauma that occurred shortly before its appearance. We report a case of a 34-month-old child who was referred to the emergency room with a significant vaginal hemorrhage, originating from a wide laceration of the posterior fourchette, and a negative history for accidental trauma...
August 23, 2016: International Journal of Legal Medicine
Dirk Dethleff, Nils Weinrich, Birgitt Kowald, Dorothea Hory, Rüdiger Franz, Maja Verena Nielsen, Klaus Seide, Christian Jürgens, Markus Stuhr
OBJECTIVE: Our purpose was 2-fold: 1) to show emergency-related traumatic injury and acute disease patterns and 2) to evaluate air rescue process times in a remotely located German offshore wind farm. Optimally, this will support methodologies to reduce offshore help time (time from the incoming emergency call until offshore arrival of the helicopter). METHODS: The type and severity of traumatic injuries and acute diseases were retrospectively analyzed for 39 air medevacs from August 2011 to December 2013, and the process times of air rescue missions were evaluated in detail...
July 2016: Air Medical Journal
S Peschillo, F Diana, J Berge, P Missori
BACKGROUND: It has been amply demonstrated that endovascular procedures can be successful treatment for stroke, both in terms of revascularization and clinical outcome. There is not, however, a published comparison of any histological or ultrastructural damage to the vessels that may be caused by a direct aspiration first pass technique (ADAPT) or stent retrievers (SR) used in these procedures. This study analyses and compares acute damage to the arterial wall caused by ADAPT or SR. MATERIAL AND METHODS: Damage to the walls of swine extracranial arteries was evaluated after ADAPT with the Penumbra system or thrombectomy with an SR (Solitaire 6×30)...
July 7, 2016: Journal of Neurointerventional Surgery
Ryan R Konwinski, Ajay Singh, Jorge Soto
The goal of this study is to describe the imaging features of lower extremity blast injuries in patients encountered in the radiology departments from the Boston Marathon bombings. A total of 115 patients presented to four acute care hospitals on April 15, 2013, 43 of whom presented with lower extremity injuries and were included in this study. The imaging findings of primary, secondary, tertiary, and quaternary blast injuries were evaluated. Forty-one of 43 patients sustained secondary blast injuries to the lower extremities with 31 patients (70 %) having retained shrapnel, seven patients (16 %) having soft tissue lacerations without retained shrapnel, and ten patients (23 %) having lower extremity amputation (7 % double amputees)...
October 2016: Emergency Radiology
Vito Potenza, Ubaldo Saputo, Francesco Catellani, Pasquale Farsetti, Roberto Caterini
INTRODUCTION: Injury of femoral vessels is an extremely rare complication in intertrochanteric femoral fractures. In most cases reported, the vascular lesion involves the superficial femoral artery, whereas in very few cases does it involve the profunda femoris artery. PRESENTATION OF CASE: We report a case of acute bleeding due to laceration of a perforating branch of the profunda femoris artery caused by a sharp fragment of the displaced lesser trochanter in an intertrochanteric femoral fracture; the lesion was treated by transcatheter embolization...
2016: International Journal of Surgery Case Reports
Grace L Paley, Elizabeth Echalier, Thomas W Eck, Augustine R Hong, Asim V Farooq, Darren G Gregory, Anthony J Lubniewski
PURPOSE: To report cases of acute globe rupture and bilateral corneal burns from electronic cigarette (EC) explosions. METHODS: Case series. RESULTS: We describe a series of patients with corneal injury caused by EC explosions. Both patients suffered bilateral corneal burns and decreased visual acuity, and one patient sustained a unilateral corneoscleral laceration with prolapsed iris tissue and hyphema. A review of the scientific literature revealed no prior reported cases of ocular injury secondary to EC explosions; however, multiple media and government agency articles describe fires and explosions involving ECs, including at least 4 with ocular injuries...
July 2016: Cornea
Cristian D'Ovidio, Sara Sablone, Aldo Carnevale
Angio-SealTM is a vascular closure device (VCD) that can be applied to the femoral artery following cardiac catheterization to achieve hemostasis. Although it has been demonstrated to be superior to conventional manual pressure and to reduce time to hemostasis and patient ambulation, the use of this VCD is not without its complications. In this report, we describe the case of a 55-year-old man who died due to an extremely rare event that occurred several hours after the deployment of an Angio-SealTM VCD: acute complete transverse laceration of the femoral artery that occurred because of the particular fragility of the vessel due to an unrecognized and asymptomatic arteriosclerotic disease...
September 2016: Journal of Forensic Sciences
C Willy, M Stichling, M Engelhardt, D Vogt, D A Back
The primary care of Gustilo-Anderson type IIIC extremity injuries with relevant vessel lacerations is decisive for the success of a limb salvage procedure. This article shall present substantial emergency procedures for the salvage of the nutritive perfusion of a mangled extremity, based on the current literature. After provisory control of a peripheral haemorrhage (e. g. by manual pressure or tourniquet), an immediate decision must be made about the kind of emergency revascularization to be implemented as the limb salvage procedure...
May 2016: Der Unfallchirurg
Ronald M Bilow, Kathirkamanathan Shanmuganathan, John H Harris
BACKGROUND: Terminology and classifications are the vehicles by which pathologic conditions are identified and understood. It is critically important for the patient admitted with suspected blunt thoracic aortic injury that admitting physicians have a thorough knowledge of acute traumatic aortic tear and its natural history. OBJECTIVES: The objectives of this review were as follows: (1) to introduce a pathology-based terminology and classification of acute traumatic aortic injuries that unambiguously defines each, and (2) to emphasize the clinical relevance of acute traumatic tear to post-hospital admission deaths in blunt thoracoabdominally injured patients...
August 2016: Journal of Emergency Medicine
Praveen Subudhi, Sanghamitra Kanungo, B Nageswar Rao Subudhi
BACKGROUND/PURPOSE: To report a case of atypical sympathetic ophthalmia after limbal corneal laceration. METHODS AND RESULTS: An 11-year-old child had a successful left eye corneal laceration repair at the temporal limbus with excision of exposed nonnecrotic iris tissue, resulting in good visual acuity of 20/80 and 20/25 on postoperative Days 1 and 7, respectively. The patient was prescribed 1 mg/kg oral prednisolone in a tapering dose as prophylaxis. On postoperative Day 21, the patient presented with acute onset decreased vision in both eyes...
April 27, 2016: Retinal Cases & Brief Reports
Dean Smyth, Jey Selwyn
We present a case of a 77-year-old man with a history of myeloproliferative disorder. He was admitted with a 2-week history of erythaema, swelling and significant pain of the right forearm following a mechanical fall at home, which had caused a skin laceration. During his admission, he developed ongoing intermittent fever and persistently elevated C reactive protein, and total white cell count. Initially, he was treated with antibiotics for suspected cellulitis. However, symptoms continued to progress, making a suitable management plan challenging...
2016: BMJ Case Reports
Shadi Basyuni, Andreana Panayi, Valmiki Sharma, Vijay Santhanam
INTRODUCTION: We present the case of an overlooked scalp laceration in an 81-year-old lady who presented with polytrauma following a fall down stairs. Complications that developed required more extensive treatment compared to what would have sufficed with early identification. PRESENTATION OF CASE: Imaging on admission to hospital showed multiple vertebrae and rib fractures as well as a large cranial subcutaneous haematoma with no intracerebral bleed. Before the laceration was identified, the patient developed acute anaemia requiring transfusion...
2016: International Journal of Surgery Case Reports
Seung H Yoo, Emilee Venn, Lauren A Sullivan, Christine S Olver
OBJECTIVE: To describe the thromboelastographic changes in fibrinolysis with ε-aminocaproic acid treatment in a dog with suspected acute traumatic coagulopathy. CASE SUMMARY: A 9-year-old female spayed Airedale Terrier was presented with multiple injuries consistent with motor vehicle trauma. After surgical repair of a diaphragmatic hernia and minor laceration of the right cranial lung lobe, the dog continued to produce copious volumes of hemorrhagic fluid from the thoracic cavity despite multiple plasma transfusions, autotransfusions, and failure to locate a definitive source of bleeding during 2 separate surgeries...
September 2016: Journal of Veterinary Emergency and Critical Care
Elizabeth M Bloemen, Tony Rosen, Justina A Cline Schiroo, Sunday Clark, Mary R Mulcare, Michael E Stern, Regina Mysliwiec, Neal E Flomenbaum, Mark S Lachs, Stephen Hargarten
BACKGROUND: Photographing injuries in the acute setting allows for improved documentation as well as assessment by clinicians and others who have not personally examined a patient. This tool is important, particularly for telemedicine, tracking of wound healing, the evaluation of potential abuse, and injury research. Despite this, protocols to ensure standardization of photography in clinical practice, forensics, or research have not been published. In preparation for a study of injury patterns in elder abuse and geriatric falls, our goal was to develop and evaluate a protocol for standardized photography of injuries that may be broadly applied...
May 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Tutku Soyer, Fatih Andiran, Mithat Haliloglu, Feridun Cahit Tanyel
The case of an 11-year-old girl who developed acute abdomen after an accidental fall over an iron bar is reported to discuss the diagnostic features and treatment options for traumatic rupture of a choledochal cyst (CC) in children. The patient was admitted to the emergency department with complaints of vomiting and abdominal pain. Physical examination revealed tenderness at the right upper quadrant of the abdomen. Computed tomography findings revealed a rupture of a type IV CC and laceration of the liver. Cholecystectomy, total excision of the cyst, and hepaticojejunostomy were performed...
March 2016: Pediatric Emergency Care
Marwan Youssef, Friedrich Dünschede, Hazem El Beyrouti, Ora Salem, Christian-Friedrich Vahl, Bernhard Dorweiler
Background We demonstrate our initial experience and first results of the endovascular aneurysm sealing (EVAS) technology with chimney grafts for the treatment of paravisceral aneurysms. Methods We present a consecutive series of seven patients with a mean age of 75 years who had been treated by four-vessel-chimney EVAS (ChEVAS) between May 2014 and May 2015. All patients were ASA grade ≥ III and were not eligible for fenestrated/branched endovascular aortic repair (fEVAR/brEVAR) due to urgency (n = 5) or anatomical constraints (n = 2)...
February 18, 2016: Thoracic and Cardiovascular Surgeon
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