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https://www.readbyqxmd.com/read/29161399/global-lessons-developing-military-trauma-care-and-lessons-for-civilian-practice
#1
T Woolley, J A Round, M Ingram
The wars in Iraq and Afghanistan have helped to shape the modern Defence Medical Services. Many lessons were learnt including the need for rapid haemorrhage control, senior decision-making and the evolution of deployed transfusion support. These changes were implemented simultaneously with a coherent, end-to-end medical plan from point of wounding through to rehabilitation. Implementation of the medical plan is harmonious with the NHS trauma pathway, and is key to ensuring effective delivery. Military anaesthetists have a long pre-deployment training pathway starting with a Certificate of Completion of Training (CCT) in anaesthesia and/or critical care, and with an emphasis on military skills related to their specific role...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29161213/laparoscopic-management-of-penetrating-thoracoabdominal-trauma
#2
Megan C Prunty, Siddharth Kudav, Jacob A Quick
BACKGROUND: Traumatic thoracoabdominal injuries can involve multiple organs and multiple cavities, which increases the complexity of surgical management. Traditionally, these injuries required laparotomy and thoracotomy. However, minimally invasive intervention may be reasonable for stable patients. MATERIALS AND METHODS: We present a case of a thoracoabdominal gunshot wound resulting in multiorgan, multicavity injury to the lung, diaphragm, and liver. We performed hepatorrhaphy and diaphragm repair, and addressed a retained hemothorax through a transabdominal laparoscopic approach...
November 21, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29160727/a-review-of-perioperative-complications-of-outpatient-total-ankle-arthroplasty
#3
Todd R Borenstein, Kapil Anand, Quanlin Li, Timothy P Charlton, David B Thordarson
BACKGROUND: Total ankle arthroplasty (TAA) is commonly pursued for patients with painful arthritis. Outpatient TAA are increasingly common and have been shown to decrease costs compared to inpatient surgery. However, there are very few studies examining the safety of outpatient TAA. In this study, we retrospectively reviewed 65 consecutive patients who received outpatient TAA to identify complication rates. METHODS: The medical records of 65 consecutive outpatient TAA from October 2012 to May 2016 with a minimum 6-month follow-up were reviewed...
November 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/29159427/shunt-revision-rates-in-myelomeningocele-patients-in-the-first-year-of-life-a-retrospective-study-of-52-patients
#4
Ibrahim Alatas, Gokhan Canaz, Nesrin Akkoyun Kayran, Nursu Kara, Huseyin Canaz
PURPOSE: Shunt placement indications are stringent and require confirmation of clinical and radiological evidence of hydrocephalus (HC). The aim of this study was to determine the rate of shunting and discuss the outcome in the first year of life in patients with myelomeningocele (MMC) on the basis of review of the literature. METHODS: All patients who underwent postnatal repair of MMC at our institution between March 2014 and March 2015 were evaluated. Patients were only included if they underwent both MMC repair and ventriculoperitoneal (VP) shunt insertion at our institution and were followed up for at least 12 months...
November 20, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29158651/soft-tissue-complications-in-distal-tibial-fractures-managed-with-medial-locking-plates-a-myth-or-reality
#5
Deepak Jain, Harpal Singh Selhi, Mohammad Yamin, Pankaj Mahindra
Background: Distal tibial fractures are common injuries that are prone to complications and require careful management. The use of medial periarticular locking plates is an established modality in the treatment if these fractures. These plates are inserted using the minimally invasive plate osteosynthesis (MIPO) or open technique. Our study looks at the soft tissue complications associated with the use of medial locking plates in the management of these fractures. Methods: This was a retrospective study carried out at a tertiary care university hospital in an urban setting...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29158645/evaluation-of-functional-outcome-of-pilon-fractures-managed-with-limited-internal-fixation-and-external-fixation-a-prospective-clinical-study
#6
Umesh Kumar Meena, Mahesh Chand Bansal, Prateek Behera, Rahul Upadhyay, Gyan Chand Gothwal
Introduction: The management of pilon fractures is controversial primarily due to the high rate of complications irrespective of the mode of treatment. Limited internal fixation with external fixation is associated with minimal soft tissue handling. This may reduce the chances of wound dehiscence and infection. This study was designed to evaluate the functional and clinical outcomes in patients treated with limited internal fixation combined with external fixation in pilon fractures. Material and methods: This study was conducted as a prospective clinical study on 56 skeletally mature patients with closed fractures with poor skin condition, and with open grade 1 and grade 2 distal tibial intra-articular fractures...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29158265/topical-mevastatin-promotes-wound-healing-by-inhibiting-the-transcription-factor-c-myc-via-the-glucocorticoid-receptor-and-the-long-noncoding-rna-gas5
#7
Andrew P Sawaya, Irena Pastar, Olivera Stojadinovic, Sonja Lazovic, Stephen C Davis, Joel Gil, Robert S Kirsner, Marjana Tomic-Canic
Diabetic foot ulcers (DFU), a life-threatening complication of diabetes mellitus, have limited treatment options, often resulting in amputations. HMG-CoA reductase inhibitors such as statins are cholesterol-reducing agents that may provide a new therapeutic option. Statins target the cholesterol pathway and block the synthesis of the wound-healing inhibitors farnesyl pyrophosphate (FPP) and cortisol, ligands for the glucocorticoid receptor (GR). Here we demonstrate that the naturally occurring statin, mevastatin, reverses FPP's effects and promotes healing by using in vitro wound healing assays, human ex vivo and porcine in vivo wound models, and DFU tissue...
November 20, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/29157841/acute-management-of-high-energy-lisfranc-injuries-a-simple-approach
#8
Dolfi Herscovici, Julia M Scaduto
INTRODUCTION: The aims of this study were to (1) describe the use of the K-wire for the initial management of high-energy Lisfranc dislocations or fracture dislocations, (2) to evaluate whether this standalone technique allowed for adequate reduction of these injuries, (3) to evaluate whether reductions were maintained until definitive fixation was performed, (4) and to determine if it contributed to any increase in complications prior to or after definitive fixation. PATIENTS AND METHODS: A retrospective review was performed on all patients who presented with tarsometatarsal injuries from January 2005 through June 2015...
November 16, 2017: Injury
https://www.readbyqxmd.com/read/29157827/supplementation-with-tocotrienols-from-bixa-orellana-improves-the-in-vivo-efficacy-of-daptomycin-against-methicillin-resistant-staphylococcus-aureus-in-a-mouse-model-of-infected-wound
#9
Elisa Pierpaoli, Fiorenza Orlando, Oscar Cirioni, Oriana Simonetti, Andrea Giacometti, Mauro Provinciali
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is a common cause of skin and soft-tissue infection worldwide. An adequate immune response acts as a first line of defence against infections and therefore plays an essential role in the maintenance of health. Tocotrienols (T3s), the lesser known isomers of vitamin E, possess many biological properties and have been recognized as immunomodulators. PURPOSE: The aim of this study was to investigate whether the in vivo supplementation with a mixture of 87...
December 1, 2017: Phytomedicine: International Journal of Phytotherapy and Phytopharmacology
https://www.readbyqxmd.com/read/29156232/use-of-negative-pressure-wound-therapy-after-infection-and-flap-dehiscence-in-radical-vulvectomy-a-case-report
#10
Antoni Llueca, Jose Luis Herraiz, Raquel Del Moral, Dolors Piquer, Yasmine Maazouzi, Blanca Segarra, Jordan Barres, Anna Serra
INTRODUCTION: Vulvar cancer has a lower incidence in high income countries, but is rising, in part, due to the high life expectancy in these societies. Radical vulvectomy is still the standard treatment in initial stages. Wound dehiscence contitututes one of the most common postoperative complications. PRESENTATION OF CASE: A 76year old patient with a squamous cell carcinoma of the vulva, FIGO staged, IIIb is presented. Radical vulvectomy and bilateral inguinal lymph node dissection with lotus petal flaps reconstruction are performed as the first treatment...
November 6, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29156159/amnion-the-ideal-scaffold-for-treating-full-thickness-wounds-of-the-lower-extremity
#11
REVIEW
Bryon McKenna, N Jake Summers
Amnion and amniotic tissue has been studied for more than 100 years in the treatment of acute and chronic wounds. Recent studies have focused on the use of amnion tissue in the management of full-thickness diabetic wounds, particularly of the lower extremities. With new harvesting, processing, and distribution technologies, amnion is increasingly available in treating these wounds. Current data and research show increased healing potential and decreased healing times, pain, drainage, and infection in wounds treated with amnion products...
January 2018: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/29155250/surgical-management-of-acute-appendicitis-in-adults-a-review-of-current-techniques
#12
REVIEW
Maximilian Sohn, Ayman Agha, Stefan Bremer, Kai S Lehmann, Marcus Bormann, Alfred Hochrein
Acute appendicitis is one of the most frequent disorders in abdominal surgery. Therefore, appendectomy is a matter of significant interest in that field. Yet, four different techniques are available: open appendectomy, (conventional) laparoscopic appendectomy, single port laparoscopic appendectomy and NOTES-appendectomy with its different variations. To evaluate the current state of the art in appendectomy a bibliographic search was conducted. All prospectively randomized trials and national register cohort studies published between 1/2010 and 5/2016 were included into the analysis...
November 18, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29155110/delayed-traumatic-aortic-pseudoaneurysm-formation-causing-vertebral-body-erosion-and-back-pain-case-report-and-literature-review
#13
Justin M Cappuzzo, Kathleen E Knudson, Shawn Sarin, Joseph Babrowicz, Abraham Cherrick, Jonathan H Sherman
BACKGROUND: Aortic pseudoaneurysms are a rare cause of chronic back pain, usually due to compression of adjacent neurovasculature. It is uncommon for patients with pseudoaneurysms of the abdominal aorta to present in a delayed fashion after initial traumatic injury. CASE DESCRIPTION: We present an unusual case of delayed pseudoaneurysm formation, with subsequent erosion into the adjacent L1 vertebral body. This pseudoaneurysm was secondary to a gunshot wound with retained ballistic fragment that occurred 27 years prior...
November 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29154457/complications-from-microfocused-transcutaneous-ultrasound-case-series-and-review-of-the-literature
#14
Daniel P Friedmann, Gregory P Bourgeois, Henry H L Chan, Ann C Zedlitz, Kimberly J Butterwick
BACKGROUND AND OBJECTIVE: Microfocused ultrasound (MFUS) technology has been utilized since 2009 for improvement in mild to moderate skin and soft tissue laxity of the face and neck. Few complications have been previously reported, the majority of which include mild and transient erythema, edema, ecchymosis, and nerve paralysis. Rare yet serious potential complications of MFUS for noninvasive skin tightening of the face and neck are, however, possible. METHODS & MATERIALS: Retrospective multicenter case series of five patients from the authors' practice who developed serious adverse events directly related to MFUS with a commercially available device (Ultherapy; Merz North America, Inc...
November 20, 2017: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/29153451/a-novel-minimally-invasive-surgery-combined-with-early-exercise-therapy-promoting-tendon-regeneration-in-the-treatment-of-spontaneous-achilles-tendon-rupture
#15
Amuding Aisaiding, Jianping Wang, Rouziwanguli Maimaiti, Ayidaer Jialihasia, Rakimbaiev Aibek, Bayixiati Qianman, Nuerai Shawutali, Aynaz Badelhan, Wulan Bahetiya, Aliya Kubai, Mailamuguli Kelamu, Yeermike Nuerdoula, Elihaer Makemutibieke, Yerzat Bakyt, Jianati Wuerliebieke, Jiasharete Jielile
OBJECTIVE: Acute closed spontaneous Achilles tendon rupture often occurs in elderly individuals and is usually accompanied with many complications. Conventional surgical approaches to remove the tendon lesions and enthesophytes are highly traumatic and cause complications. In this study, a previously established minimally invasive surgical approach was modified and combined with a Kazakh exercise therapy to reduce trauma, improve wound healing, and promote tendon regeneration in the management of acute closed spontaneous Achilles tendon rupture...
October 31, 2017: Injury
https://www.readbyqxmd.com/read/29153225/are-there-clinical-signs-and-symptoms-of-infection-to-indicate-the-presence-of-multidrug-resistant-bacteria-in-venous-ulcers
#16
Silvana de Lima Vieira Dos Santos, Marlene Andrade Martins, Marinésia Aparecida do Prado, José Verdú Soriano, Maria Márcia Bachion
The selection of topical and systemic therapies for the treatment of venous ulcers with signs of infection is challenging and should be accompanied by specific precautionary measures to protect against cross-contamination in the presence of multidrug-resistant microorganisms. However, there are still no clinical indicators for this situation, and confirmation of resistant strains occurs through culture and sensitivity, which can take up to 14 days. During this period, protective measures may no longer be taken, contributing to the spread of these pathogens...
December 2017: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
https://www.readbyqxmd.com/read/29151894/-fast-cast-and-needle-tenotomy-protocols-with-the-ponseti-method-to-improve-clubfoot-management-in-bangladesh
#17
Angela Evans, Mamun Chowdhury, Sohel Rana, Shariar Rahman, Abu Hena Mahboob
Background: The management of congenital talipes equino varus (clubfoot deformity) has been transformed in the last 20 years as surgical correction has been replaced by the non-surgical Ponseti method. The Ponseti method, consists of corrective serial casting followed by maintenance bracing, and has been repeatedly demonstrated to give best results - regarded as the 'gold standard' treatment for paediatric clubfoot. Methods: To develop the study protocol Level 2 evidence was used to modify the corrective casting phase of the Ponseti method in children aged up to 12 months...
2017: Journal of Foot and Ankle Research
https://www.readbyqxmd.com/read/29151703/3d-printed-fistula-stent-designed-for-management-of-enterocutaneous-fistula-an-advanced-strategy
#18
Jin-Jian Huang, Jian-An Ren, Ge-Fei Wang, Zong-An Li, Xiu-Wen Wu, Hua-Jian Ren, Song Liu
Enterocutaneous fistulas (ECFs) are great challenges during the open abdomen. The loss of digestive juice, water-electrolyte imbalance and malnutrition are intractable issues during management of ECF. Techniques such as "fistula patch" and vacuum-assisted closure therapy have been applied to prevent contamination of open abdominal wounds by intestinal fistula drainage. However, failures are encountered due to high-output fistula and anatomical complexity. Here, we report 3D-printed patient-personalized fistula stent for ECF treatment based on 3D reconstruction of the fistula image...
November 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29151402/difference-in-first-aid-activity-during-mass-casualty-training-based-on-having-taken-an-educational-course
#19
Youichi Yanagawa, Kazuhiko Omori, Kouhei Ishikawa, Ikuto Takeuchi, Kei Jitsuiki, Toshihiko Yoshizawa, Jun Sato, Hideyuki Matsumoto, Masaru Tsuchiya, Hiromichi Osaka
BACKGROUND: The Japanese Association for Disaster Medicine developed a mass casualty life support (MCLS) course to improve cooperation among medical practitioners during a disaster, which is essential for reducing the rates of preventable disaster death. We investigated whether there was difference in first aid activity among members of the ambulance service during mass casualty training based on having taken the MCLS course. METHODS: Mass casualty training was held at the fire department of Numazu City...
November 20, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/29149388/problems-of-reconstructive-cranioplasty-after-traumatic-brain-injury-in-children
#20
Paolo Frassanito, Gianpiero Tamburrini, Luca Massimi, Simone Peraio, Massimo Caldarelli, Concezio Di Rocco
Cranial repair after traumatic brain injury in children is still burdened by unsolved problems and controversial issues, mainly due to the high rate of resorption of autologous bone as well as the absence of valid alternative material to replace the autologous bone. Indeed, inert biomaterials are associated to satisfactory results in the short period but bear the continuous risk of complications related to the lack of osteointegration capacity. Biomimetic materials claiming osteoconductive properties that could balance their mechanical limits seem to allow good cranial bone reconstruction...
October 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
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