Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Feb 2012
Hip fracture surgery and performance indicators: an analysis of 941 patients operated in a large teaching hospital.
In the Netherlands, two performance indicators for the treatment of hip fracture patients have been recently implemented. Both indicators state that surgery within 24 h after admission improves the outcome with regard to 1-year mortality and the amount of re-operations within 1 year. To determine the value of these performance indicators, we conducted a retrospective analysis of 941 hip fracture patients. ⋯ We conclude that hip fracture surgery within 24 h does not provide significantly better results in terms of 1-year mortality and the amount of re-operations within 1 year.
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Eur J Trauma Emerg S · Feb 2012
Biomechanical comparison of two locking plate systems for the distal tibia.
Distal tibia fractures are known to be difficult to stabilize and nonunions often occur because of a relative instability of the fragments. Therefore, it was of interest to ascertain how different locking plates behave regarding stiffness and interfragmentary movement in comminuted distal tibia fractures. ⋯ The treatment of distal tibia fractures with angle-stable medial AxSOS plate showed less interfragmentary movement and higher stiffness than fracture fixation with a locked medial LCP. Even if there are no significant differences in torsional testing, plating of the distal tibia should be performed with a steel plate from the biomechanical view.
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Eur J Trauma Emerg S · Feb 2012
Evaluating the effects of immediate application of negative pressure therapy after decompression from abdominal compartment syndrome in an experimental porcine model.
The purpose of this large-animal study was to assess the safety and effects of negative pressure therapy (NPT) when used as temporary abdominal closure in the immediate post-decompression period after abdominal compartment syndrome (ACS). ⋯ Early application of NPT in this porcine ACS model is safe and does not appear to be associated with an increased risk of recurrent intra-abdominal hypertension. The results of this animal study suggest that the application of NPT following decompression from ACS results in greater peritoneal fluid removal and may translate into augmented intestinal edema resolution secondary to more favorable fluid flux profiles.
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Eur J Trauma Emerg S · Feb 2012
Open to laparoscopic conversion in hemoperitoneum of unknown origin.
Demonstrating the potential, in spite of the current trend, of closing an open emergency surgical procedure and to convert it to a minimally invasive approach. ⋯ For selected cases, the conversion of an open procedure to a laparoscopic approach offers a real benefit for the patient, avoiding a large laparotomy and its associated morbidity.
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Eur J Trauma Emerg S · Feb 2012
Regionalisation of trauma care in Germany: the "TraumaNetwork DGU(®)-Project".
The care for severely injured patients is a demanding task for all medical professionals involved in both the pre-clinical and the clinical setting. While the overall quality of care in Germany is high, regional differences remain. These are due to geographical and infrastructural variations, as well as different personnel and equipment situations in the hospitals. ⋯ The TraumaNetwork DGU(®) audits all hospitals participating in the care for severely injured patients and establishes a structured network between all the players involved in trauma care. Thirty TNWs will be certified by the end of 2011, covering 75% of Germany. The nationwide covering will be completed by the middle of 2012.