J Trauma
-
Comparative Study
Snowboarding injuries of the chest: comparison with skiing injuries.
Snowboarding injuries have become more common with the remarkable increase in the sport's popularity. However, although there are many reports of orthopedic injuries caused by snowboarding, there are few reports on injuries to the chest. In this study, we attempted to identify the characteristics of snowboarding injuries of the chest in comparison with alpine skiing injuries. ⋯ A riding mistake during improper jumping may be the primary cause of chest snowboarding injuries. Furthermore, snowboarders are much more likely to injure the chest, particularly by rib fractures, than skiers.
-
An accurate assessment of deep dermal burns within the first week after burn is still an unresolved clinical problem. Infrared-excited fluorescence of indocyanine green was examined as a method of early determination of burn depth. ⋯ Deep partial-thickness burns were differentiated from deep dermal full-thickness burns in a porcine skin burn model independent of body location. Diagnosis was possible between 1 and 72 hours after injury.
-
To determine the ability of an externally applied continuous negative abdominal pressure device (CNAP) to reverse the effects of elevated intra-abdominal pressure on the central nervous and cardiovascular systems. ⋯ Acutely elevated IAP causes a significant increase in ICP and impaired cardiovascular and pulmonary function. Abdominal decompression remains the standard of care for abdominal compartment syndrome. However, in patients in whom an increased IAP does not require surgical decompression, the results of this study suggest that externally applied CNAP may be of value.
-
In Norway, most patients with severe head injuries are transported to, and operated in, the neurosurgical unit of the regional university hospital. However, some patients are still occasionally operated on in county central hospitals by orthopedic or general surgeons who do not have neurosurgical expertise. The aim was to analyze this surgical activity outside the neurosurgical units. ⋯ The present study indicates that, in Norway and countries with a similar hospital system, it must be difficult for general and orthopedic surgeons to achieve and maintain the skills required for emergency operations in patients with acute severe head injuries. Thus, it is probably to the patients' benefit to improve the general hospitals' competency and speed in the detection of candidates for surgical decompression, and stress the importance of these patients being transferred without unnecessary delay to a neurosurgical unit.
-
We conducted a prospective study in patients with multiple injuries investigating the time course of trauma-related changes of systemic immunologic defense mechanisms. ⋯ In patients who died of severe trauma and in whom the cause of death was multiple organ failure, a significantly lower production of antiendotoxin antibodies was measured shortly before death. An insufficient immune defense (dysergy) may be involved in the pathomechanisms leading to the development of organ dysfunction.