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https://www.readbyqxmd.com/read/28891977/polytrauma-defined-by-the-new-berlin-definition-a-validation-test-based-on-propensity-score-matching-approach
#1
Cheng-Shyuan Rau, Shao-Chun Wu, Pao-Jen Kuo, Yi-Chun Chen, Peng-Chen Chien, Hsiao-Yun Hsieh, Ching-Hua Hsieh
Background: Polytrauma patients are expected to have a higher risk of mortality than that obtained by the summation of expected mortality owing to their individual injuries. This study was designed to investigate the outcome of patients with polytrauma, which was defined using the new Berlin definition, as cases with an Abbreviated Injury Scale (AIS) ≥ 3 for two or more different body regions and one or more additional variables from five physiologic parameters (hypotension [systolic blood pressure ≤ 90 mmHg], unconsciousness [Glasgow Coma Scale score ≤ 8], acidosis [base excess ≤ -6...
September 11, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28888300/heterotopic-ossification-and-hypertrophic-scars
#2
REVIEW
Shailesh Agarwal, Michael Sorkin, Benjamin Levi
Burns and trauma cause superficial and deep soft tissue wounds that cannot heal to the preinjury state. Healing requires cell proliferation and differentiation into the injured tissue type, laying down extracellular matrix, often as collagens. Heterotopic ossification causes severe pain, nonhealing wounds, and restricted range of motion. Treatment includes radiation therapy, nonsteroidal anti-inflammatory drugs, bisphosphonates, and possibly surgical excision and prophylactic measures. Hypertrophic scars, nonosseous lesions caused by excessive collagen deposition, are often painful, functionally limiting, and aesthetically displeasing...
October 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28885215/hyperspectral-imaging-as-a-novel-diagnostic-tool-in-microcirculation-of-wounds
#3
Georg Daeschlein, Inga Langner, Thomas Wild, Sebastian von Podewils, Claudia Sicher, Thomas Kiefer, Michael Jünger
Monitoring of perfusion is a cornerstone in surgery, phlebology and basic science to proof wound healing by interventions. In chronic wound management it is of utmost importance to realize and parametrize wound bed perfusion to verify actual, and plan further treatment by noninvasive diagnostics. Up to now monitoring is based on visual inspection of wounds as conventionally practiced over more than decades. The main problems of visual inspection are the lack of standardization and comparability because of interindividual variations...
September 4, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28876577/surgical-burden-of-disease-at-a-regional-hospital-in-south-africa
#4
O Swart, J Pape, R Duvenage
BACKGROUND: There is limited published data describing the nature of surgical admissions at a regional level in the South African context. Worcester Hospital General Surgery has introduced an electronic online database to manage its surgical services. This study uses that database to evaluate the surgical burden of disease for the Cape Winelands East and Overberg districts of the Western Cape. METHOD: Admissions data were prospectively captured from February 2012 to January 2016, then retrospectively reviewed and classified into 5 types: (1) elective surgery/investigations (ESI); (2) trauma; (3) burns; (4) non-traumatic surgical emergencies (NTSE); (5) unplanned readmission within 30 days...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28873104/management-of-trauma-and-burn-scars-the-dermatologist-s-role-in-expanding-patient-access-to-care
#5
Nathanial R Miletta, Matthias B Donelan, Chad M Hivnor
Recent advances in laser surgery and our understanding of wound healing have ushered in a new era of trauma and burn scar management. Traditional therapy has centered around scar excision followed by primary closure or tissue replacement with flaps and grafts. This approach represents a perpetuation of the common fallacy that extensive scar improvement requires extensive surgical intervention. Laser surgery in conjunction with pharmacotherapy and minor tissue-conserving surgery produces well-healed and remodeled existing tissue that provides the most natural appearance and function of the skin...
July 2017: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/28871936/xanthoma-like-skin-changes-in-an-elderly-woman-with-a-normal-lipid-profile
#6
Piotr Nockowski, Zdzisław Woźniak, Adam Reich, Joanna Maj
Dear Editor, An 83-year-old woman developed yellow-brownish infiltrates, nodules, and tumors mimicking xanthomas, mostly involving the periorbital and chest area within three months (Figure 1). She had no abnormalities in serum cholesterol or triglycerides levels. A detailed laboratory analysis revealed the presence of mild monoclonal gammopathy with a presence of immunoglobulin G (IgG) kappa light chains; however, according to hematologist consultation, it did not require medical intervention. Imaging assessment and ultrasound examination did not show any specific involvement of internal organs...
July 2017: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/28871333/-thermal-injuries-clinical-and-acute-management-in-pediatric-practice
#7
REVIEW
K Schriek, M Sinnig
BACKGROUND: Each year 30,000 children suffer from burn injuries in Germany and 2000 of these children must be treated in special pediatric burn centers. Approximately two thirds of these children are less than 4 years old, 70% of thermal injuries are due to scalding with hot liquids. OBJECTIVES: The aim of this article is to give an overview of the characteristics of pediatric burn trauma with recommendations for initial treatment, surgical therapy as well as follow-up treatment...
September 4, 2017: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/28869385/microneedling-a-form-of-collagen-induction-therapy-our-first-experiences
#8
H Šuca, R Zajíček, Z Vodsloň
INTRODUCTION: Microneedling (percutaneous collagen induction therapy) is a new promising miniinvasive therapeutic method for the treatment of skin alterations of different aetiology, including burn scars. Since 2016, it is also available at our department. The microtraumatization of scars with the Dermaroller® leads to an activation of the healing cascade, activation of growth factors, which activate cell proliferation in the wound, increased synthesis and deposit of collagen - elastin complex with successive transformation of collagen III to collagen I, to neoangiogenesis and thus to accelerated scar remodelling...
2017: Acta Chirurgiae Plasticae
https://www.readbyqxmd.com/read/28869384/micromycetes-infection-in-patients-with-thermal-trauma
#9
B Lipový, J Holoubek, H Řihová, Y Kaloudová, M Hanslianová, M Cvanová, J Jarkovský, I Suchánek, P Brychta
GOAL: Determination of basic epidemiological parameters of burn patients with micromycetes infection. Identification of the most important micromycetes in burn patients. MATERIAL AND METHODS: Monocentre retrospective study enrolling all adult burn patients who were hospitalized between 2007 and 2015 and in whom micromycetes were isolated during hospitalization. ABSI index (Abbreviated Burn Severity Index) was used to evaluate severity of thermal trauma. Results were statistically analysed...
2017: Acta Chirurgiae Plasticae
https://www.readbyqxmd.com/read/28869383/experience-with-integra%C3%A2-at-the-prague-burns-centre-2002-2016
#10
R Zajíček, I Grossová, H Šuca, R Kubok, I Pafčuga
INTRODUCTION: Integra® dermal replacement has a wide spectrum of use both in burn medicine as well as in reconstructive plastic surgery and traumatology. Since 2002, it has been a part of surgical treatment of patients at Prague Burns Centre of the Královské Vinohrady Teaching Hospital. STUDY GROUP: Integra® was used in 47 patients in total between years 2002 and 2016. In this group there were 28 paediatric patients and 19 adult patients. Eleven children were operated during the reconstructive period, 8 children had an acute injury...
2017: Acta Chirurgiae Plasticae
https://www.readbyqxmd.com/read/28869381/meek-micrografting-technique-and-its-use-in-the-treatment-of-severe-burn-injuries-at-the-university-hospital-ostrava-burn-center
#11
H Klosová, Z Němečková Crkvenjaš, J Štětinský
BACKGROUND: Early necrectomy and skin autotransplantation are prerequisites for successful treatment of extensive burns. Insufficient autograft donor site availability is a limiting factor. The Meek micrografting technique, published by C. P. Meek in 1958, appears to be a potential solution. Skin grafts are cut into micrografts and expanded at a ratio of 1:3, 1:4, 1:6 or 1:9. Thus, even in cases with limited donor site availability, it is possible to cover large areas after necrectomy...
2017: Acta Chirurgiae Plasticae
https://www.readbyqxmd.com/read/28867537/thermal-injury-of-the-skin-induces-g-csf-dependent-attenuation-of-epo-mediated-stat-signaling-and-erythroid-differentiation-arrest-in-mice
#12
John G Noel, Benjamin J Ramser, Jose A Cancelas, Francis X McCormack, Jason C Gardner
Inflammation mediated impairment of erythropoiesis, plays a central role in the development of the anemia of critical illness (ACI). ACI develops despite elevation of endogenous erythropoietin (EPO), does not respond to exogenous EPO supplementation, and contributes significantly to transfusion requirements in burned patients. We have previously reported that the reduction of red blood cell mass in the bone marrow of a burn-injured ACI mouse model is G-CSF dependent. Given that elevated G-CSF levels have also been associated with lower hemoglobin levels and increased transfusion requirements in trauma victims, we postulated that G-CSF mediates post burn EPO resistance...
August 31, 2017: Experimental Hematology
https://www.readbyqxmd.com/read/28864102/presenting-hypertension-burn-injury-and-mortality-in-combat-casualties
#13
Anders J Davidson, Sarah-Ashley E Ferencz, Jonathan A Sosnov, Jeffrey T Howard, Jud C Janak, Kevin K Chung, Ian J Stewart
INTRODUCTION: The effect of presenting hypertension is poorly studied in combat casualties. We hypothesized that elevated mean arterial pressure (MAP) on presentation to combat hospitals would be associated with poor outcomes. METHODS: Data was obtained from the Department of Defense Trauma Registry and the Armed Forces Medical Examiner System. Variables analyzed included presenting vital signs to Role II-III military theater hospital, demographic variables, injury severity score (ISS), location and mechanism of injury, presence of traumatic brain injury (TBI), acute kidney injury (AKI), and mortality...
August 29, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28855060/trauma-mechanisms-and-injury-patterns-in-pediatric-burn-patients
#14
Theres Moehrlen, Thomas Szucs, Markus A Landolt, Martin Meuli, Clemens Schiestl, Ueli Moehrlen
The objective of this study was to evaluate the frequency, severity, exact patterns and mechanisms of burn injuries in children. The patient records of children with acute burns admitted to the University Children's Hospital of Zurich were retrospectively reviewed over an 11year period. The age group with the highest risk, were children under the age of five (69%). Boys were overrepresented in all age groups, but the gender imbalance increased with age. Infants and toddlers were mainly injured by scalds and contact burns...
August 27, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28853121/characteristics-of-us-combat-veterans-2001-2011-who-remain-on-active-duty-after-upper-extremity-amputations
#15
Sara H Kift, Taylor J Bates, Nathan A Franklin, Anthony E Johnson
OBJECTIVES: Return to duty following traumatic amputations has been extensively studied in those with lower extremity amputation. As upper extremity amputations occur less frequently, the issue of return to duty for those with upper extremity amputations has received relatively little research. The purpose of this study was to determine the rate at which service members remain on active duty at least one year after having sustained traumatic upper extremity amputations during Operation Iraqi Freedom, Operation Enduring Freedom, and other overseas contingency operations of the Global War on Terrorism...
July 2017: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/28852298/reconstructions-of-small-scalp-defects-with-step-flap
#16
Ali Ebrahimi, Nasrin Nejadsarvari, Azin Ebrahimi
INTRODUCTION: Defects of the scalp arise from several aetiologies including trauma, burn, injury, infection, radiation and surgical excision of tumours. Multiple options for reconstruction of scalp defects exist that included primary closure, skin grafts, local flaps, regional and distal free flaps. PATIENTS AND METHODS: This was a prospective case-series study, which was carried out in the Department of Plastic Surgery of our Hospital. Step flap was used for small (2...
April 2017: Journal of Cutaneous and Aesthetic Surgery
https://www.readbyqxmd.com/read/28833130/inducible-satellite-cell-depletion-attenuates-skeletal-muscle-regrowth-following-a-scald-burn-injury
#17
Celeste C Finnerty, Colleen F McKenna, Lauren A Cambias, Camille R Brightwell, Anesh Prasai, Ye Wang, Amina El Ayadi, David N Herndon, Oscar E Suman, Christopher S Fry
Severe burns result in profound skeletal muscle atrophy; persistent muscle atrophy and weakness are major complications that hamper recovery from burn injury. Many factors contribute to the erosion of muscle mass following burn trauma, and we have previously shown concurrent activation and apoptosis of muscle satellite cells following a burn injury in pediatric patients. To determine the necessity of satellite cells during muscle recovery following a burn injury, we utilized a genetically modified mouse model (Pax7(CreER) -DTA) that allows for the conditional depletion of satellite cells in skeletal muscle...
August 22, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28831517/-terrorist-attack-trauma-an-individual-entity-of-polytrauma-a-10-year-update
#18
REVIEW
C Güsgen, A Franke, S Hentsch, E Kollig, R Schwab
The incidence of terrorist attacks is increasing worldwide, and they have also become a permanent threat in European cities. Due to its complexity, terrorist attack trauma places high demands on the strategy of surgical treatment. The combination of various mechanisms, explosions and gunshot injuries, with the characteristic pressure (blast) damage and a high proportion of penetrating trauma with simultaneous burns are characteristic features. Unlike in military conflicts, injuries to people of all ages and without ballistic body protection (body armor) are to be expected...
August 22, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28826842/retinoid-roles-and-action-in-skeletal-development-and-growth-provide-the-rationale-for-an-ongoing-heterotopic-ossification-prevention-trial
#19
Maurizio Pacifici
The majority of skeletal elements develop via endochondral ossification. This process starts with formation of mesenchymal cell condensations at prescribed sites and times in the early embryo and is followed by chondrogenesis, growth plate cartilage maturation and hypertrophy, and replacement of cartilage with bone and marrow. This complex stepwise process is reactivated and recapitulated in physiologic conditions such as fracture repair, but can occur extraskeletally in pathologies including heterotopic ossification (HO), Ossification of the Posterior Longitudinal Ligament (OPLL) and Hereditary Multiple Exostoses (HME)...
August 18, 2017: Bone
https://www.readbyqxmd.com/read/28826296/recent-progresses-in-plastic-surgery-using-adipose-derived-stem-cells-biomaterials-and-growth-factors
#20
Farshad Zarei, Babak Negahdari
Plastic and reconstructive surgery is a distinct specialty, which entails craniofacial and hand surgery; trauma, oncologic and congenital reconstruction; burn care, and aesthetic surgery. However, advances in nanotechnology have significantly affected wound management, skin care, implant and prosthetic design, tissue engineering, and drug delivery systems. Presently, plastic surgeons are applying the efficacy of stem cells (ADSCs), biomaterials and growth factors in different facets of plastic surgery. In this review, we will elucidate the applications of stem cells, biomaterials and growth factors in plastic surgeries...
August 21, 2017: Journal of Microencapsulation
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