The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Feb 2014
Comparative StudyShould blunt segmental vascular renal injuries be considered an American Association for the Surgery of Trauma Grade 4 renal injury?
Renal segmental vascular injury (SVI) following blunt abdominal trauma is not part of the original American Association for the Surgery of Trauma (AAST) renal injury grading system. Recent recommendations support classifying SVI as an AAST Grade 4 (G4) injury. Our primary aim was to compare outcomes following blunt renal SVI and blunt renal collecting system lacerations (CSLs). We hypothesize that renal SVI fare well with conservative management alone and should be relegated a less severe renal AAST grade. ⋯ Epidemiologic study, level IV.
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J Trauma Acute Care Surg · Feb 2014
Multicenter StudyMulticenter review of diaphragm pacing in spinal cord injury: successful not only in weaning from ventilators but also in bridging to independent respiration.
Ventilator-dependent spinal cord-injured (SCI) patients require significant resources related to ventilator dependence. Diaphragm pacing (DP) has been shown to successfully replace mechanical ventilators for chronic ventilator-dependent tetraplegics. Early use of DP following SCI has not been described. Here, we report our multicenter review experience with the use of DP in the initial hospitalization after SCI. ⋯ Therapeutic study, level V.
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J Trauma Acute Care Surg · Feb 2014
Comparative StudyOutcomes of acute versus elective primary ventral hernia repair.
The morbidity and mortality associated with acute primary ventral hernia repair have not been well described. We examined the rate of surgical site infection (SSI), hernia recurrence, and mortality in acute versus elective primary ventral hernia repair and identified predictors of morbidity and mortality after primary ventral hernia repair. ⋯ Therapeutic study, level IV.
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J Trauma Acute Care Surg · Feb 2014
Multicenter StudyGunshot wounds and blast injuries to the face are associated with significant morbidity and mortality: results of an 11-year multi-institutional study of 720 patients.
Gunshot wounds and blast injuries to the face (GSWBIFs) produce complex wounds requiring management by multiple surgical specialties. Previous work is limited to single institution reports with little information on processes of care or outcome. We sought to determine those factors associated with hospital complications and mortality. ⋯ Therapeutic/care management, level III.
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J Trauma Acute Care Surg · Feb 2014
Flail chest injuries: a review of outcomes and treatment practices from the National Trauma Data Bank.
Flail chest injuries are associated with severe pulmonary restriction, a requirement for intubation and mechanical ventilation, and high rates of morbidity and mortality. Our goals were to investigate the prevalence, current treatment practices, and outcomes of flail chest injuries in polytrauma patients. ⋯ Epidemiologic/prognostic study, level IV.