Eur J Trauma Emerg S
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There is a lack of knowledge on respiratory and physical function, mobility and pain following stabilising surgery for 'flail chest'. The purpose of this study was, therefore, to evaluate pain, respiratory function, range of motion and physical function/activity 3 and 6 months after stabilising surgery in patients with 'flail chest' due to trauma. ⋯ Patients who had undergone stabilising surgery due to 'flail chest' showed decreased range of motion 3 and 6 months after surgery. Despite decreased range of motion and remaining pain, the breathing movements are synchronic.
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Eur J Trauma Emerg S · Oct 2013
Symptomatic venous thromboembolism in Asian major trauma patients: incidence, presentation and risk factors.
Trauma patients are known to be at increased risk of venous thromboembolism (VTE), and pulmonary embolism (PE) is one of the preventable causes of mortality in trauma patients. The incidence of VTE in Asian populations was believed to be lower than in Caucasians, but the recent literature suggests that this is not the case. The purpose of this study was to assess the incidence of VTE in Asian major trauma patients and to examine the manner of presentation, use of prophylaxis and risk factors for VTE. While other studies of VTE have addressed general and high-risk populations within Asia, our study is one of the few to examine Asian major trauma patients. ⋯ The incidence of symptomatic VTE in the Asian trauma population is no lower than in the West. The incidence found in this study is similar to the incidence of VTE according to a study using data from the American national trauma data bank using similar study methods and with a similar study population. It is also higher than the incidence in the literature for general post-surgical Asian patients. Fever was the presenting factor in some patients and screening for VTE should not be forgotten when assessing fever in the trauma patient. The strong association between head injury, spinal cord injury and VTE confirms that we should pay special attention to VTE prophylaxis for our patients with these injuries.
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Eur J Trauma Emerg S · Aug 2013
Impact of fluid therapy on apoptosis and organ injury during haemorrhagic shock in an oxygen-debt-controlled pig model.
Apoptosis, or programmed cell death, seems to play a role in the physiology of shock. The influence of fluid resuscitation on the occurrence of apoptosis during haemorrhage is still unclear. Using an experimental randomised study, the goal of this investigation was to find a relation between different frequently used resuscitation fluids and evidence of apoptosis. ⋯ The different resuscitation fluids used in the treatment of haemorrhagic shock in this experimental model showed no evidence of a different apoptosis rate in the end organs.
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Severe lower limb trauma with significant soft tissue injury can be managed with reconstruction or, if this is impossible, amputation. If amputation is considered, below-knee amputation preserving limb length is optimal for long-term functional outcome. ⋯ The procedure was technically challenging and required follow-up debulking operations. However, the technique provided the significant advantage of immediate sensation of robust glabrous distal stump cover and optimising leg length to enhance functional outcome.