J Trauma
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Local hemostatics have recently been introduced for field use to control external hemorrhage. The objective of this report is to describe the initial clinical experience with QuikClot, a zeolite that works by absorbing water and concentrating coagulation factors to stop bleeding in a series of patients. ⋯ QuikClot has been effectively used by a wide range of providers in the field and hospital to control hemorrhage.
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Nonoperative management of blunt splenic injury (BSI) has become the standard of care for hemodynamically stable patients. Successful nonoperative management raises two related questions: (1) what is the time course for splenic healing and (2) when may patients safely return to usual activities? There is little evidence to guide surgeon recommendations regarding return to full activities. Our hypothesis was that time to healing is related to severity of BSI. ⋯ Although mild BSIs heal faster than severe BSIs, nearly 10% of all the BSIs followed as outpatients worsened. Close observation of patients with BSI should continue until healing can be confirmed.
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Seizures are important neurologic complications of traumatic brain injury (TBI). There is a need for better delineation of potential prognostic factors and outcomes in patients with posttraumatic seizures (PTS) who could receive treatment when brought to the hospital. ⋯ Seizures are an important neurologic complication of TBI. Regarding the potentially side effects of antiepileptic drugs, antiepileptic therapy should be carefully administrated in those nonexcellent outcome patients.
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: The aim of this study was to develop a tool which can be used to do a collaborative and prospective survey on the epidemiologic characteristics, treatment and outcome of maxillofacial trauma in China and to ameliorate the existing score and treatment methods of maxillofacial trauma. ⋯ : The system has satisfactory stability, security, compatibility, and specialty. It can be used to collect standard cases of maxillofacial trauma and to do a collaborative research on the epidemiologic characteristics, treatment, and outcome of facial injuries. MISS is more accurate, objective, and credible than ISS and RFISS in reflecting the severity of maxillofacial trauma and evaluating the curative effect and prognosis.
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A flap that carries sufficient tissue with satisfactory pedicle length or diameter and with minor donor site morbidity is an ideal option for the reconstructive surgeon. Many flaps have been described with each one having specific advantages. The vastus lateralis (VL)-muscle flap is among them, but no special attention has been given to its valuable use. To evaluate and to propagate the versatility of the free VL-muscle flap, this flap was used in different pathology and in different anatomic areas. ⋯ The free VL-muscle flap is a versatile flap that offers specific advantages such as constant anatomy, ease of dissection in supine position, long pedicle length, large vessel diameter, good esthetic outcome, and minor donor site morbidity. This flap has proven to be most valuable also in difficult cases, including head and neck and lower limb reconstruction.