Injury
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Quality improvement programmes are an important part of care delivery in trauma centres. The objective was to describe the effect of a comprehensive quality improvement programme on long term patient outcome trends at a low volume major trauma centre in Australia. ⋯ In this low volume major trauma centre, the implementation of a comprehensive quality improvement programme was associated with a reduction in crude and risk adjusted mortality and risk adjusted discharge to rehabilitation in severely injured patients.
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Multicenter Study Comparative Study
Population-based analysis of blunt splenic injury management in children: Operative rate is an informative quality of care indicator.
In hemodynamically normal children with blunt splenic injury (BSI), the standard of care is non-operative management. Several studies have reported that non-paediatric and non-trauma centres have higher operative rates in children with BSI compared to paediatric hospitals and trauma centres. We investigate the feasibility of using operative rate for BSI as a quality of care indicator. ⋯ III, Retrospective comparative study.
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Randomized Controlled Trial Comparative Study
Wound closure of leg fasciotomy: Comparison of vacuum-assisted closure versus shoelace technique. A randomised study.
Fasciotomies, though essential for the prevention and management of compartment syndromes, may increase morbidity and prolong hospitalisation. Two widely applied methods of delayed primary closure are compared in leg fasciotomy wounds. ⋯ Both VAC® and the shoelace technique are safe, reliable and effective methods for closure of leg fasciotomy wounds. VAC® requires longer time to definite wound closure and is far more expensive than the shoelace technique, especially when additional skin grafting is required.
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Multicenter Study
Assessment of quality of life and functional outcome in patients sustaining moderate and major trauma: A multicentre, prospective cohort study.
Trauma care systems aim to reduce both death and disability, yet there is little data on post-trauma health status and functional outcome. ⋯ For patients sustaining moderate or major trauma in Hong Kong at 12 months after injury<1 in 10 patients had an excellent recovery, ≤3 in 10 reached a physical health status score≥Hong Kong norm, although as many as 6 in 10 patients had a mental health status score which is≥Hong Kong norm.