Injury
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Damage control laparotomy for trauma (DCL) entails immediate control of haemorrhage and contamination, temporary abdominal closure (TAC), a period of physiological stabilisation, then definitive repair of injuries. Although immediate primary fascial closure is desired, fascial retraction and visceral oedema may dictate an alternate approach. Our objectives were to systematically identify and compare methods for restoration of fascial continuity when primary closure is not possible following DCL for trauma, to simplify these into a standardised map, and describe the ideal measures of process and outcome for future studies. ⋯ Component separation or mesh repair may be valid alternatives to delayed primary closure following a trauma DCL. Comparisons were hampered by the lack of uniform reporting and bias. We propose a new system of standardised nomenclature and reporting for further investigation and management of the post-DCL open abdomen.
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Continued exposure to compensation systems has been reported as deleterious to the health of participants. Understanding the associations with time to claim closure could allow for targeted interventions aimed at minimising the time participants are exposed to the compensation system. ⋯ Health and insurance related factors are independently associated with time to claim closure. Both factors need to be considered by insurers in their assessment of complexity of claims. Interventions aimed at minimising the impact of these factors could reduce claimants' exposure to the compensation system. In turn insurers can potentially reduce claims duration and cost, while improving the health outcomes of claimants.
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Pelvic fractures are usually the result of high-energy trauma. In addition to the underlying disruption of the pelvic ring extensive damage to the surrounding soft tissue envelope might be present. ⋯ Recently another method has been reported the so called pelvic Bridge or Infix technique. In this short review article the different techniques of pelvic fixation are described.
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Fall is an important cause of injury morbidity in older adults. However, epidemiological information on fall is limited in low- and middle-income countries. We investigated the extent, pattern, characteristics, and context of falls in Chandigarh. ⋯ Fall injuries were common in older adults of Chandigarh. Large cohort studies are needed to identify risk factors particularly those related to home environment.
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Post-traumatic residual haemothorax (RH) is common and carries significant morbidity. However, its optimal treatment is not clear. ⋯ Post-traumatic RH is seen in 1/3rd patients and is equally well treated by VATS and IPSI.