European journal of trauma and emergency surgery : official publication of the European Trauma Society
-
Eur J Trauma Emerg Surg · Aug 2020
Terrorist attacks: common injuries and initial surgical management.
Terrorism-related incidents and shootings that involve the use of war weapons and explosives are associated with gunshot and blast injuries. Despite the perceived threat of terrorism, these incidents and injuries are rare in Germany. For this reason, healthcare providers are unlikely to have a full understanding of the special aspects of managing these types of injuries. ⋯ Unlike damage control surgery, which is tailored to the patient's condition, tactical abbreviated surgical care (TASC) is first and foremost adapted to the overall situation. Once the patients are stabilised and all information on the situation is available, the surgical management and reconstruction of gunshot and blast injuries can follow the principles of damage control (DC) and definitive early total care (ETC). The purpose of this article is to provide an overview of the pathophysiology of gunshot and blast injuries, wound ballistics, and the approach and procedures of successful surgical management.
-
Eur J Trauma Emerg Surg · Aug 2020
Early cranioplasty associated with a lower rate of post-traumatic hydrocephalus after decompressive craniectomy for traumatic brain injury.
Post-traumatic hydrocephalus (PTH) is one of the primary complications during the course of traumatic brain injury (TBI). The aim of this study was to define factors associated with the development of PTH in patients who underwent unilateral decompressive craniectomy (DC) for TBI. ⋯ Our results show that early cranioplasty within 2 months after DC was associated with a lower rate of PTH development after TBI.
-
Mass-casualty terrorist incidents are a medical and organisational challenge for every hospital. The Terror and Disaster Surgical Care (TDSC®) course was developed because such incidents are associated with special injury patterns, escalating situations, and surges of casualties and haemodynamically unstable patients requiring treatment and can overwhelm the resources of hospitals. ⋯ The TDSC course complements already established courses and provides training in tactical surgical care after hospital admission. The TDSC course integrates and builds on elements of individualised trauma care such as the primary survey and the extended focused assessment with sonography in trauma (eFAST). This underlines again that it complements and does not replace other course formats. We can conclude that the presentations and the tabletop simulation game were well suited to the target group and that the participants were able to increase their knowledge of this complex subject.
-
Eur J Trauma Emerg Surg · Aug 2020
Readmission after antibiotic management of uncomplicated acute appendicitis in adults: prospective study.
Acute appendicitis is the most common surgical cause of acute abdomen. Many randomized studies compare between antibiotic and surgery, and such studies indicated that antibiotics might treat acute appendicitis. However, there are concerns about selection bias in previous studies. Hence, to overcome this worry; we used in this study a full-scale population-based application. ⋯ Antibiotics are a safe and visible option in acute appendicitis management. This approach needs careful assessment and evaluation for each individual patient before it is used as the first-line therapy.
-
Eur J Trauma Emerg Surg · Aug 2020
Validity of the Korean Triage and Acuity Scale for predicting 30-day mortality due to severe trauma: a retrospective single-center study.
Since January 2016, emergency medical centers in South Korea have used the Korean Triage and Acuity Scale (KTAS) as the initial triage tool for all patients, including trauma patients, who visited the emergency department (ED). This present study aimed to assess the validity of the KTAS for predicting 30-day mortality due to severe trauma. ⋯ Lower KTAS levels were associated with higher 30-day mortality due to severe trauma. KTAS shows adequate validity for predicting 30-day mortality from severe trauma.