The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Dec 2016
Early resuscitation with lyophilized plasma provides equal neuroprotection compared with fresh frozen plasma in a large animal survival model of traumatic brain injury and hemorrhagic shock.
Combined traumatic brain injury (TBI) and hemorrhagic shock (HS) is highly lethal. In previous models of combined TBI + HS, we showed that early resuscitation with fresh frozen plasma (FFP) improves neurologic outcomes. Delivering FFP, however, in austere environments is difficult. Lyophilized plasma (LP) is a logistically superior alternative to FFP, but data are limited regarding its efficacy for treatment of TBI. We conducted this study to determine the safety and long-term outcomes of early treatment with LP in a large animal model of TBI + HS. ⋯ Early treatment with LP in TBI + HS is safe and provides neuroprotection that is comparable to FFP.
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J Trauma Acute Care Surg · Dec 2016
A single-center retrospective review of postoperative infectious complications in the surgical management of mandibular fractures: Postoperative antibiotics add no benefit.
Mandibular fractures are common facial injuries and treatment may be complicated by post-operative infection. Risk of infection from contamination with oral flora is well established but no consensus exists regarding antibiotic prophylaxis. The purpose of this study is to assess risk factors and perioperative antibiotics on surgical site infection (SSI) rates following mandibular fracture surgery. ⋯ Therapeutic study, level IV.
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J Trauma Acute Care Surg · Dec 2016
A decade of hospital-based violence intervention: Benefits and shortcomings.
Initial analyses of hospital-based violence intervention programs (VIPs) have demonstrated decreased violent injury recidivism. Long-term VIP performance has not been assessed. Violence intervention program quality improvement requires evaluation to identify shortcomings and client subpopulations warranting additional resources. We evaluated our case manager-based VIPs to identify modifiable risk factors that most impact violent injury recidivism and determine subpopulations that need modification of targeted services. ⋯ Therapeutic study, level III.