European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Jun 2015
ReviewThe pathophysiology, diagnosis and treatment of the acute coagulopathy of trauma and shock: a literature review.
The acute coagulopathy of trauma and shock is associated with significant mortality and, currently, there are no validated laboratory tests which allow for a rapid recognition and treatment of this condition. Therefore, early detection of any clot abnormality in trauma could improve the diagnosis of trauma-associated coagulopathy and subsequent interventions. ⋯ There is enough evidence to demonstrate that we urgently need a robust test, which would determine and quantify both the rate and the extent of coagulation abnormalities. This could help to tailor the treatment of coagulopathy according to the patient's needs.
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Pancreatic injuries are relatively uncommon but present a major challenge to the surgeon in terms of both diagnosis and management. Pancreatic injuries are associated with significant mortality, primarily due to associated injuries, and pancreas-specific morbidity, especially in cases of delayed diagnosis. Early diagnosis of pancreatic trauma is a key for optimal management, but remains a challenge even with more advanced imaging modalities. ⋯ For main pancreatic ductal injury, surgery remains the preferred approach with distal pancreatectomy for most injuries and more conservative surgical management for proximal ductal injuries involving the head of the pancreas. More recently, nonoperative management has been utilized, especially in the pediatric population, with the potential for increased rates of pseudocyst and pancreatic fistulae and the potential for the need for further intervention and increased hospital stay. This review presents recent data focusing on the diagnosis, management, and outcomes of blunt pancreatic injury.
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The diagnosis, workup and management of blunt renal injury have evolved greatly over the past decades. Evaluation and management of blunt renal injury echoes the increasing success of nonoperative management in other blunt abdominal solid organ injury, such as liver and spleen. ⋯ Emerging techniques in highly sensitive imaging as well as interventional angiography have allowed safe nonoperative management in the appropriate patient. This review will focus on the contemporary workup and management of blunt renal injury while focusing on some of the emerging literatures in regard to refined imaging and grading of injuries as well as techniques to increase the success of nonoperative management.
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Eur J Trauma Emerg Surg · Jun 2015
Biomechanical properties of different external fixator frame configurations.
External fixators are easy to apply and maximize soft tissue preservation. However, frames need providing an adequate stiffness in order to avoid excessive interfragmentary movement during the healing period. We characterized the stiffness of four different configurations of the newly developed Hoffmann 3 external fixation system. ⋯ The diameter and the amount of used connecting rods as well as the adequate placement of these rods towards the main loading directions determine the construct stiffness. These results could help the surgeons estimating how different frames can potentially affect the interfragmentary motion. This information might help in choosing specific configuration when treating different fracture types on given patients.
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Eur J Trauma Emerg Surg · Jun 2015
Young adults with mild traumatic brain injury-the influence of alcohol consumption-a retrospective analysis.
Alcohol abuse has been associated with aggressive behavior and interpersonal violence. Aim of the study was to investigate the role of alcohol consumption in a population of young adults with mild traumatic brain injuries and the attendant epidemiological circumstances of the trauma. ⋯ Among young adults men and unemployed men have a higher statistical probability to have consumed alcohol prior to suffering mild traumatic brain injury. The most common trauma mechanism in this age group is interpersonal violence and occurs more often in patients who have consumed alcohol. Alcohol consumption and interpersonal violence increase the odds ratio for concomitant injuries, open wounds, and fractures independently from another.