The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Feb 2012
Early complications associated with cephalomedullary nail for intertrochanteric hip fractures.
Use of cephalomedullary devices for pertrochanteric fractures has been associated with complications of cutout, fracture distal to the tip of the implant, infection, and hardware failure. The goal of recent design changes (a trapezoidal shape of the proximal device, with interdigitation of the cephalocervical screws) in cephalomedullary nails was to improve fracture fixation and stability of pertrochanteric fractures. This is a retrospective review of the first 127 surgeries using this new cephalomedullary nail to review early complications seen with this device. ⋯ In our study population, we found this newer cephalomedullary device had complications similar to those reported with devices in previous studies.
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J Trauma Acute Care Surg · Feb 2012
Readmission of trauma patients in a nonacademic Level II trauma center.
Readmission of trauma patients has been identified as a quality indicator for trauma care. Few if any studies on this topic can be found from a nonacademic trauma center. The objectives of the study were to determine the rate, cause, and preventability for readmission and to identify predictors of readmission in a nonacademic trauma center. ⋯ The incidence of readmissions was similar to published data from academic trauma centers, but the reason for readmission and the need for surgery at readmission were very different. Potentially preventable readmissions have not been well addressed in literature. Therefore, further multicenter studies that include nonacademic trauma centers are needed to analyze this complicated problem.
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J Trauma Acute Care Surg · Feb 2012
CPSI-121 pharmacologically prevents intestinal barrier dysfunction after cutaneous burn through a vagus nerve-dependent mechanism.
We have recently demonstrated the protective effects of electrical stimulation of the vagus nerve in prevention of gut injury after severe burn. Here we evaluate the potential for a pharmacologic agonist of the vagus nerve as an approach to regulate outcomes in preclinical models. We tested a new generation of guanylhydrazone-derived compounds, CPSI-121; a compound that may activate the parasympathetic nervous system through poorly understood mechanisms to determine whether we could prevent intestinal mucosal barrier breakdown. ⋯ Similar to direct electrical VNS, CPSI-121 effectively protects the intestinal mucosal barrier from breakdown after severe burn. We suggest that this could represent a noninvasive therapy to prevent end-organ dysfunction after trauma that would be administered during resuscitation.