J Trauma
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Comparative Study
A comparison of Abbreviated Injury Scale 1980 and 1985 versions.
The 1980 and 1985 versions of the Abbreviated Injury Scale (AIS) are quantitatively and qualitatively compared based on experience gained during the recent coding of nearly 115,000 injuries from more than 33,000 seriously injured patients using both AIS versions. Quantitative comparisons are based on differences in AIS scores and Injury Severity Score (ISS) values which result under the two schemes. Qualitative comparisons concern the completeness and clinical usability of the two scales in a trauma center setting.
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Forty-five consecutive patients with penetrating thoraco-abdominal trauma underwent surgical exploration to evaluate the ability of peritoneal lavage to detect peritoneal penetration. Eight patients fulfilled standard criteria for operation and did not undergo lavage. The remaining 37 patients underwent diagnostic peritoneal lavage using a closed technique before exploratory laparotomy. ⋯ While 33% of this patient cohort were found to have significant injuries (four had isolated diaphragmatic injuries, all detected by peritoneal lavage), 67% were subjected to negative surgical exploration, as accurately predicted by peritoneal lavage. Negative laparotomy carried a 10.7% operative morbidity. Based on these data we advocate diagnostic peritoneal lavage in patients with thoraco-abdominal penetrating trauma who otherwise lack operative indications.
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Historical Article
The surgical effects of wound ballistics of October war weapons.
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Live, anesthetised pigs were used to assess behind-armour blunt trauma effects. The thoraco-abdominal body region was covered with varying thicknesses of Kevlar fabric packets. This soft body armour was applied, either in direct contact with the thoracic wall of the animals, or with different plastic foam sheets, so-called trauma packs, between the armour and the skin. ⋯ Blocks of soft soap were subjected to equal tests and the behind-armour indentations were measured. The results indicate that serious injury to the body armour-protected chest may be caused by the impact of nonpenetrating bullets and shotgun pellets. Severe pulmonary contusions and lacerations were found when the energy transferred through the body armour was estimated to be high.