J Trauma
-
The purpose of this study was to describe the functional status and quality of life (QOL) of patients at 12 months after injury. ⋯ Patients who survive injuries experience residual impairments in FC and QOL for as long as 1 year after injury. Changes to the long-term management of these patients should be considered.
-
Locking plates are an alternative to conventional compression plate fixation for diaphyseal fractures. The objective of this study was to compare the stability of various plating with locked screw constructs to conventional nonlocked screws for fixation of a comminuted diaphyseal fracture model using a uniform, synthetic ulna. Locked screw construct variables were the use of unicortical or bicortical screws, and increasing bone to plate distance. ⋯ These results support the use of plating with bicortical locked screws as an alternative to conventional plating for comminuted diaphyseal fractures in osteoporotic bone. Bicortical locked screws with minimal displacement from the bone surface provide the most stable construct in the tested synthetic comminuted diaphyseal fracture model. The results of this study suggest use of plates with unicortical screws for the described fracture is not recommended.
-
Four recent reports of the retrieval of optional vena cava filters (VCF) in trauma patients had average implant durations of 10, 19, and 19 days (one not specified). Two patients in these studies had pulmonary emboli after VCF removal. No evidence-based guidelines exist on the appropriate time to remove optional VCF. The purpose of this study was to examine the timing of pulmonary emboli (PE) and determine the optimal time to remove optional VCFs. ⋯ Clinical criteria defining the time to remove optional VCFs without exposing patients to the risk of PE by removing a filter too soon should be determined.
-
Skin stretching harnesses the same viscoelastic properties of the skin as expansion, with the difference that the forces are applied externally and not internally. An improvised system for wound closure is presented. ⋯ This system permits the closure of wounds not suitable for closure by primary intention and avoids the use of skin grafts or flaps.
-
Although transcriptional profiling is a well-established technique, its application to systematic studying of various biological phenomena is still limited because of problems with high-volume data analysis and interpretation. This research project's objective was to create a comprehensive summary of changes in gene expression after hemorrhagic shock (HS), reliant and impartial of multiple variables, such as resuscitation treatments, organ analyzed, and time after impact. ⋯ We have reliably identified genes and pathways that are affected by HS and are responsive to resuscitation. Gene expression in various organs is affected differentially by HS, which can be further modulated by the choice of resuscitation strategy.