J Trauma
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Comparative Study
Hepatic arterial embolization in the management of blunt hepatic trauma: indications and complications.
The objective was to clarify the role of hepatic arterial embolization (AE) in the management of blunt hepatic trauma. ⋯ AE is a key element in modern management of high-grade liver injuries. Two principal indications exist in the acute postinjury phase: primary hemostatic control in hemodynamically stable or stabilized patients with radiologic computed tomography evidence of active arterial bleeding and adjunctive hemostatic control in patients with uncontrolled suspected arterial bleeding despite emergency laparotomy. Successful management of injuries of grade III upward often entails a combined angiographic and surgical approach. Awareness of the ischemic complications due to angioembolization is important.
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Case Reports
Clinical application of the flap based on the distal cutaneous branch of the ulnar artery.
To introduce our experiences of using the flap based on the distal cutaneous branch of the ulnar artery. ⋯ Because the flap does not compromise the dominant hand arteries and provides a reliable blood supply, it is a good choice for soft tissue reconstruction of defects in the dorsal and palmar aspects of the hand.
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Comparative Study
Thirteen survivors of prehospital thoracotomy for penetrating trauma: a prehospital physician-performed resuscitation procedure that can yield good results.
Prehospital cardiac arrest associated with trauma almost always results in death. A case of survival after prehospital thoracotomy was published in 1994 and several others have followed. This article describes the result of prehospital thoracotomy in a physician-led system for patients with stab wounds to the chest who suffered cardiac arrest on scene. ⋯ Prehospital thoracotomy is a well-established procedure in this physician-led prehospital service. Results from this and other similar systems suggest that when performed for the subgroup of patients described, significant numbers of survivors with good neurologic outcome can be expected.