World journal of surgery
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World journal of surgery · Nov 2007
Early management of gunshot injuries to the face in civilian practice.
Gunshot injuries to the face in civilian practice are rarely reported. Potential complications in the Emergency Department can have catastrophic consequences, and inappropriate operative management of the facial soft and skeletal tissues are related to outcome. ⋯ Gunshot injury to the face in civilian violence is a "benign" condition as long as the Patient's airway is kept patent and hemorrhage is controlled. Early operative intervention for repair of the soft and skeletal facial structures leads to satisfactory results. Mortality directly related to the facial trauma is uncommon.
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World journal of surgery · Nov 2007
Epidemiology and contemporary patterns of trauma deaths: changing place, similar pace, older face.
The epidemiology of trauma deaths in Europe is less than well investigated. Thus, our goal was to study the contemporary patterns of trauma deaths within a defined population with an exceptionally high trauma autopsy rate. ⋯ While pre-hospital and early deaths still predominate, an increasing proportion succumb after arrival in hospital. Focus on injury prevention is imperative, particularly for brain injuries. Although hemorrhage and multiorgan failure deaths have decreased, they do still occur. Redirected attention and focus on the geriatric trauma population is mandated.
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World journal of surgery · Nov 2007
Review Meta AnalysisEfficacy and safety of Seprafilm for preventing postoperative abdominal adhesion: systematic review and meta-analysis.
There is no clear consensus on the efficacy and safety of hyaluronate-carboxymethylcellulose membrane (Seprafilm) for preventing postoperative abdominal adhesion. This study is a meta-analysis of the available evidence. ⋯ Our systematic review and meta-analysis showed that Seprafilm could decrease abdominal adhesions after general surgery, which may benefit patients, but could not reduce postoperative intestinal obstruction. At the same time, Seprafilm did increase abdominal abscesses and anastomotic leaks.
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World journal of surgery · Nov 2007
Vacuum-assisted wound closure and mesh-mediated fascial traction--a novel technique for late closure of the open abdomen.
Open abdomen (OA) treatment often results in difficulties in closing the abdomen. Highest closure rates are seen with the vacuum-assisted wound closure (VAWC) technique. However, we have experienced occasional failures with this technique in cases with severe visceral swelling needing longer treatment periods with open abdomen. Feasibility and short-term outcome of a novel combination of techniques for managing the open abdomen are presented. ⋯ Delayed primary closure in cases with severe visceral swelling and long periods of OA seems feasible with this technique.
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The practice of surgical trainees operating in developing countries is gaining interest in the medical community. Although there has been little analysis about the ethical impact of these electives, there has been some concerns raised over the possible exploitation of trainees and their patients. ⋯ Advanced surgical trainees who have already achieved surgical competence are best qualified to satisfy these ethical issues. All training programs need to develop a structured ethical review for international electives to protect their trainees and their patients from harm.