Eur J Trauma Emerg S
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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
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
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
Sigmoid volvulus treated by resection and primary anastomosis: urgent and elective conditions as risk factors for postoperative morbidity and mortality.
Sigmoid volvulus is a major cause of intestinal obstruction. The aim of this study is to analyze urgent and elective conditions as risk factors for morbidity and mortality regarding sigmoid colon resection and primary anastomosis in patients with sigmoid volvulus. ⋯ Sigmoid colon resection plus primary anastomosis-related morbidity and mortality rates were similar in patients who were operated on under urgent and elective conditions, and who maintained good general condition.