Canadian journal of surgery. Journal canadien de chirurgie
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The spleen is the most commonly injured visceral organ in blunt abdominal trauma in both adults and children. Nonoperative management is the current standard of practice for patients who are hemodynamically stable. However, simple observation alone has been reported to have a failure rate as high as 34%; the rate is even higher among patients with high-grade splenic injuries (American Association for the Surgery of Trauma [AAST] grade III-V). ⋯ We discuss the role of computed tomography and transcatheter splenic artery embolization in the diagnosis and treatment of blunt splenic trauma. We review technical considerations, indications, efficacy and complication rates. We also propose an algorithm to guide the use of angiography and splenic embolization in patients with traumatic splenic injury.
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Comparative Study
Drilling sounds are used by surgeons and intermediate residents, but not novice orthopedic trainees, to guide drilling motions.
The purpose of our study was to investigate the impact of distracting noise on the performance on a simulated orthopedic bone drilling skill when that noise blocks routine auditory feedback associated with the sounds of the drill. ⋯ Distracting noise impairs orthopedic bone drilling performance, and the ability to use drilling sounds to guide drilling motions is part of surgical expertise.