Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Feb 2012
Prognostic value of various intracranial pathologies in traumatic brain injury.
Various intracranial pathologies in traumatic brain injury (TBI) can help to predict patient outcomes. These pathologies can be categorised using the Marshall Classification or the Abbreviated Injury Scale (AIS) dictionary or can be described through traditional descriptive terms such as subarachnoid haemorrhage (SAH), subdural haemorrhage (SDH), epidural haemorrhage (EDH) etc. The purpose of this study is to assess the prognostic value of AIS scores, the Marshall Classification and various intracranial pathologies in TBI. ⋯ In this relatively recent dataset, each of the brain injury classification systems enhanced equally the performance of an early mortality prediction model in traumatic brain injury patients. The significant effect of brain swelling and brain stem injury on the outcome in comparison to injuries such as SAH suggests the need to improve therapeutic approaches to patients who have sustained these injuries.
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Eur J Trauma Emerg S · Feb 2012
Evidence for improved outcome following use of hemostatic fibrin sealants in HPB surgery?
The development of fibrin sealants has been progressing; they are now often applied as fibrinogen-coated collagen patches. ⋯ High quality evidence in the form of major prospective, randomized clinical studies is still lacking on in the field of HPB. There is also an the absence of proper cost-utility analyses.
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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.
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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.