Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Dec 2011
Physiological assessment of the polytrauma patient: initial and secondary surgeries.
The timing of fracture fixation in polytrauma patients has been debated for a long time. The decision between DCO (damage control orthopaedics) and ETC (early total care) is a difficult dilemma. Overzealous ETC in haemodynamically compromised patients with significant chest and head injuries can be detrimental. ⋯ The literature shows equivocal evidence for both settings. This article will summarize the historical background and controversies regarding patient assessment and decision making during the treatment of polytrauma patients. It will also give guidance for choosing DCO versus ETC in the clinical setting.
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Eur J Trauma Emerg S · Dec 2011
The treatment of traumatic shock: recent advances and unresolved questions.
Uncontrolled bleeding remains a leading cause of potentially preventable death after trauma. Timely, adequate resuscitation in traumatic shock is an essential, lifesaving aspect of polytrauma care. ⋯ The increase in knowledge regarding the pathophysiology of trauma, the availability of adjuncts, and the array of resuscitation monitoring options available have all contributed to a potentially improved approach to resuscitation. The purpose of this report is to review the most important advances in traumatic shock therapy in the last five years.
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Eur J Trauma Emerg S · Dec 2011
Reliability of measurement techniques for the hepato-splanchnic region in multiple-trauma patients.
Relevant information on the adequacy of intestinal perfusion is needed. The objective of our study was to investigate the relationship between the difference in intra-mucosal and arterial CO2 pressure (pCO2 gap) and the outcome in multiply injured patients and relations between the pCO2 gap and intestinal permeability (IP). ⋯ The pCO2 gap in trauma patients on intra-gastric enteral nutrition in the phase of present technical solutions has no prognostic value for the development of MOF, but IP correlated with it.
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Eur J Trauma Emerg S · Dec 2011
Implant removal associated complications in children with limb fractures due to trauma.
The purpose of this study was to analyze the number and type of complications that occurred after fracture implant removal and to investigate whether implant removal should be performed routinely in children. ⋯ The removal of K-wires, ESIN, and screws is considered to be a safe procedure in children and is, by definition, indicated for K-wires and ESIN after fracture healing.