Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Aug 2012
Correlation of operative and pathological injury grade with computed tomographic grade in the failed nonoperative management of blunt splenic trauma.
Computed tomography (CT) is the standard for grading blunt splenic injuries, but the true accuracy, especially for grade IV or V injuries as compared to pathological findings, is unknown. ⋯ CT for splenic injury is accurate for grades I and II, but underestimates the true extent of injury for grades III-V. The reasons for the lack of correlation are the inability to determine hilar involvement and excessive perisplenic blood obscuring the injury. Patients with these image characteristics by CT scan should undergo splenectomy earlier if there are any signs of hemodynamic instability.
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Eur J Trauma Emerg S · Aug 2012
Pelvic circumferential compression devices (PCCDs): a best evidence equipment review.
Traumatic disruption of the pelvis can lead to significant morbidity and mortality. ATLS(®) guidance advocates temporary stabilisation or 'closure' of the disrupted pelvis with a compression device or sheet. We undertook a best evidence equipment review to assess the ease and efficacy of the application of two leading commercially available devices, the T-POD(®) and the SAM Pelvic Sling™ II. ⋯ The results of this study indicate that both PCCDs are easy and acceptable to use and, once learned, can be applied easily and rapidly. Participants applied both devices correctly 100% of the time, with successful application taking, on average, less than 60 s.
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Eur J Trauma Emerg S · Aug 2012
Clinical re-evaluation of the relationship between gluteal injuries and embolized arteries in patients with massive hemorrhage following pelvic fracture.
Transcatheter angiographic embolization (TAE) has been widely accepted as a treatment for hemorrhagic shock associated with pelvic fracture. Gluteal muscle necrosis is a rare but potentially fatal complication of TAE. This study aimed to clarify factors associated with safer embolization procedures by evaluating relationships between embolic site and risk of gluteal skin injury. ⋯ If possible, we recommend selective embolization avoiding the superior and inferior gluteal arteries.
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Eur J Trauma Emerg S · Aug 2012
Low incidence of penetrating trauma in a high-volume tertiary center: 10-year mortality review.
Trauma morbidity and mortality outcome is better in high-volume trauma centers. However, there are few publications investigating the experience of high-volume centers with high non-trauma emergency load but seeing a relatively low incidence of trauma. The objective of this study is to review the presentation and outcomes for the low volume of patients presenting with penetrating injuries in a high-volume hospital. ⋯ With a trauma system in place, high-volume centers with a low volume of penetrating injury patients can still manage uncommon injuries without jeopardizing patient care.
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Eur J Trauma Emerg S · Aug 2012
Chronic pain and its impact on quality of life following a traumatic rib fracture.
Traumatic rib fractures account for 7-40 % of trauma admissions and most of them heal spontaneously and do not contribute to disability. The prevalence of chronic pain and its impact on quality of life following a traumatic rib fracture has not been studied adequately. ⋯ This study confirms the high incidence of chronic pain after a traumatic rib fracture. While the majority of the patients can manage this pain without interference of their quality of life, a few do suffer from life style/work interference and may have to resort to regular analgesic usage.