European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Aug 2017
Observational StudyUsability and effectiveness of Suprathel(®) in partial thickness burns in children.
Evaluation of usability and effectiveness of Suprathel® in the treatment of partial thickness burns in children. ⋯ Suprathel® provides potential advantages regarding pain and scar formation, but extensive wound debridement is needed to achieve adequate adherence.
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The aim of this study was to analyze epidemiologic data of patients with head injuries (HI) who were admitted to the Trauma and Emergency Surgery Department. ⋯ The number of traffic accidents and assaults were considerably higher in the young adult population compared with the other age groups. Traffic accidents accounted for 46.6 % of the mortality rate. Mortality in HI patients mostly arises from preventable conditions, and the young adult population seems to be the most affected group. HI should be considered as a public health issue, and prevention of HI should be the primary goal.
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Eur J Trauma Emerg Surg · Aug 2017
Gustilo type IIIC open tibia fractures with vascular repair: minimum 2-year follow-up.
Salvage or amputation for grade 3C open fracture of tibia is not well responded question universally because of surgical innovations, cultural believes, difficulties in estimate the outcome, coasts, and different results in the literature. The aim of this study was to evaluate the surgical outcomes of Gustilo grade 3C open tibia fractures with at least two years follow-up in non-military adults. ⋯ Scoring systems and the ischemic time are not the only predictors of amputation. The decision of the treatment mode should be made by the patient and the care team after discussing the options and outcomes rather than relying on a scoring system.
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Eur J Trauma Emerg Surg · Aug 2017
Observational StudyThe characteristics and pre-hospital management of blunt trauma patients with suspected spinal column injuries: a retrospective observational study.
Pre-hospital spinal immobilisation by emergency medical services (EMS) staff is currently the standard of care in cases of suspected spinal column injuries. There is, however, a lack of data on the characteristics of patients who received spinal immobilisation during the pre-hospital phase and on the adverse effects of immobilisation. The objectives of this study were threefold. First, we determined the pre-hospital characteristics of blunt trauma patients with suspected spinal column injuries who were immobilised by EMS staff. Second, we assessed the choices made by EMS staff regarding spinal immobilisation techniques and reasons for immobilisation. Third, we researched the possible adverse effects of immobilisation. ⋯ Spinal immobilisation was applied in 96.3 % of all included patients based on pre-hospital criteria. We found that consensus among EMS staff on how to interpret the criterion 'distracting injury' was lacking. Furthermore, the adverse effects of spinal immobilisation were incompletely documented in pre-hospital care reports. To provide validated information on potential symptoms of SCI, a uniform EMS scoring system for motoric assessment should be developed.
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Eur J Trauma Emerg Surg · Aug 2017
The impact of pre-injury direct oral anticoagulants compared to warfarin in geriatric G-60 trauma patients.
Pre-injury oral anticoagulants are associated with worse outcomes in geriatric (G-60) trauma patients, but there are limited data comparing warfarin with direct oral anticoagulants (DOAC). We sought to compare outcomes in G-60 trauma patients taking pre-injury DOACs vs. warfarin. ⋯ Pre-injury DOACs are not associated with worse clinical outcomes compared to warfarin in G-60 trauma patients. Higher use of pharmacologic reversal agents with warfarin may be related to differences in mechanism of action and effect on INR.