J Trauma
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A helmet mandatory for people younger than 16 years was implemented in most Austrian provinces in the winter season 2009/2010. The objective of this study was to evaluate the impact of a ski helmet mandatory on age-dependent helmet use. ⋯ A helmet mandatory for people aged 15 years or less may increase helmet use in involved age groups when helmet use is relatively low. However, public discussions and preventive helmet campaigns based on sound theories of health behavior change may also induce increases in helmet use in skiers aged older than 15 years without helmet mandatory.
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Our objective is to evaluate the mortality and outcomes of hemodynamically unstable patients with pelvic fractures treated with a protocol that directs the patient to either early pelvic angiography or early retroperitoneal pelvic packing. ⋯ Early experience in our institution suggests that early pelvic packing with subsequent angiography if needed is as good as angiography with embolization in treating patients with hemodynamically unstable pelvic fractures.
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To determine whether preinjury statin use is associated with survival and functional recovery in older adult victims of moderate/severe head trauma. ⋯ Preinjury statin use in older adult traumatic brain injury victims is associated with reduced risk of death and improved functional recovery at 12 months postinjury. Individuals with cardiovascular comorbidities lose this benefit of premorbid statin use. Statins, as possible protective agents in head trauma, warrant further study.
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Traumatic pneumomediastinum secondary to blunt chest injury in children is concerning for potential life-threatening tracheobronchial, esophageal, or vascular thoracic injuries. These patients often undergo extensive radiologic evaluation and invasive testing due to the unclear risk of traumatic pneumomediastinum. ⋯ Tracheobronchial, esophageal, or vascular thoracic injuries were uncommon in children with traumatic pneumomediastinum and occurred in the setting of additional thoracic and other organ system injuries. Pneumomediastinum without radiographic or clinical evidence of other thoracic injuries may not routinely require further diagnostic testing.
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Wound excision is the standard treatment for firearm wounds. However, achieving a satisfactory curative effect is difficult because of the traumatic mechanism of high-velocity projectiles. We propose a new therapy by using topical bromelain as a supplement to wound incision for the debridement of firearm wounds. We clarified the debriding effect of bromelain on firearm wounds in pigs. ⋯ Bromelain is effective in the debridement of uncomplicated firearm wounds if used as a supplement to simple wound incision. This new therapy shows notable advantages over conventional surgical debridement as it greatly simplifies the procedures.