The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Jun 2012
Prone positioning improves oxygenation in adult burn patients with severe acute respiratory distress syndrome.
Prone positioning (PP) improves oxygenation and may provide a benefit in patients with acute respiratory distress syndrome (ARDS). This approach adds significant challenges to patients in intensive care by limiting access to the endotracheal or tracheostomy tube and vascular access. PP also significantly complicates burn care by making skin protection and wound care more difficult. We hypothesize that PP improves oxygenation and can be performed safely in burn patients with ARDS. ⋯ Therapeutic study, level IV.
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J Trauma Acute Care Surg · Jun 2012
Neuron-specific enolase and S100BB as outcome predictors in severe diffuse axonal injury.
Diffuse axonal injury (DAI) is a common type of traumatic brain injury, mostly associated with mild changes on computed tomography (CT) scan. Serum biomarkers might be used in the diagnosis and prognosis of this injury type. Our purpose was to determine temporal profile and predictive values of serum concentrations of protein S100BB and neuron-specific enolase (NSE) after DAI. ⋯ Prognostic study, level III.
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J Trauma Acute Care Surg · Jun 2012
Comparative StudyScrew- versus plate-fixation strength of acetabular anterior column fractures: a biomechanical study.
The standard for operative treatment of acetabular fractures is open reduction and plate fixation. Recently, screw fixation-only methods through less invasive approaches are reported, but biomechanical data are missing. Questions posed in this study are (1) is the static fixation strength of different screw types equivalent to the standard plate fixation for anterior column fractures of the acetabulum? and (2) does the placement of an additional screw in the infra-acetabular corridor increase the fixation strength independent of the used implant? ⋯ Therapeutic study, level IV.
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J Trauma Acute Care Surg · Jun 2012
Surgical treatment of complex regional pain syndrome type II with regional subcutaneous venous sympathectomy.
The effectiveness of a new surgical technique for the treatment of severe chronic pain stages was evaluated. For the last 140 years, the treatment of complex regional pain syndrome type II (CRPS II) has been an unsolved problem. Therapeutic approaches have included conventional pain medication, physical therapy, sympathetic blocks, transcutaneous or spinal cord stimulation, injections or infusion therapies, and sympathectomy. When used alone or in combination, these therapies often yield unfavorable results. The majority of physicians who treat patients with CRPS are convinced that a surgical treatment of the affected extremity only exacerbates the symptoms, especially its hallmark excruciating pain. ⋯ Therapeutic study, level III.
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J Trauma Acute Care Surg · Jun 2012
Comparative StudyManagement of blunt and penetrating biliary tract trauma.
Penetrating or blunt injury to the biliary tree remains a rare complication of trauma occurring in 0.1% of trauma admissions. Because of the different presentations, sites of biliary tract injury, and associated organ injury, there are many possible management pathways to be considered. ⋯ Therapeutic study, level V.