European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Dec 2021
Meta AnalysisInferior vena cava filters reduce symptomatic but not fatal pulmonary emboli after major trauma: a meta-analysis with trial sequential analysis.
The prophylactic use of inferior vena cava filters among patients with major trauma is researched by several controlled studies with contradicting results. We performed an updated meta-analysis with trial sequential analysis of controlled studies probing the prophylactic use of inferior cava filters on the development of symptomatic and fatal pulmonary embolism (PE) in patients with major trauma. ⋯ The use of inferior vena cava filters curtailed the risk of symptomatic PE, the result further strengthened by trial sequential analysis. However, the present evidence fails to delineate a beneficial role of prophylactic inferior vena cava filter placement in reducing fatal PE among patients with major trauma. The possibility of Type II error cannot be excluded from this estimate.
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Eur J Trauma Emerg Surg · Dec 2021
Outcomes of omental patch repair in large or giant perforated peptic ulcer are comparable to gastrectomy.
Perforated peptic ulcer (PPU) complicates 2 to 10% of patients with peptic ulcer disease and has mortality risk of up to 20%. Omental patch repair is the mainstay of surgical management and gastric resectional procedures are advocated for a large/giant ulcer or suspected malignancy. Emergency gastrectomy is associated with increased morbidity and mortality. The aim of this study is to compare the outcomes of omental patch repair with gastrectomy in patients with large PPU (≥ 20 mm). ⋯ Omental patch repair confers similar perioperative outcomes as compared to gastrectomy in patients with large PPU.
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Eur J Trauma Emerg Surg · Dec 2021
The value of 3D reconstructions in determining post-operative reduction in acetabular fractures: a pilot study.
In patients with acetabular fractures, the reconstructed three-dimensional (3D) model of the contralateral acetabulum could be used as a mirrored template for the anatomical configuration of the affected joint. This has not been validated. ⋯ This study demonstrates 3D reconstructed models of healthy left and right acetabula are highly similar and could potentially be used as mirrored duplicates. The next step will be to investigate these results in patients with reduced acetabular fractures.
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Eur J Trauma Emerg Surg · Dec 2021
Consultant versus trainee led surgery and impact on outcome following an emergency colonic resection.
Emergency colonic surgery carries a high mortality rate. In the UK, strategies to improve outcomes in emergency general surgery recommend a consultant surgeon to be physically present during all operations involving a patient with a predicted mortality > 5%. To test the assertion of the consultant surgeon's presence in theatre as a determinate of improved outcome, we assessed patients following an emergency colonic resection and the effect of operator seniority. ⋯ Emergency colonic surgery remains associated with a high level of morbidity and mortality. However, consultant presence at the operating table does not appear to be the sole determinant of outcome following an emergency colonic resection.
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Eur J Trauma Emerg Surg · Dec 2021
Functional and early weight-bearing protocol for achilles tendon ruptures: a retrospective study.
Conservative treatment of achilles tendon rupture (ATR) might be favoured in centres with an early weight-bearing protocol, but no consensus exists on the clear definition of an early weight-bearing protocol. The aim of this study is to evaluate the introduction of an early weight-bearing conservative treatment protocol in patients with ATR compared to patients without this protocol. ⋯ Conservative treatment of ATR with an early weight-bearing protocol showed similar re-rupture rates and complication rates compared to conservative and operative treatments without an early weight-bearing protocol.