European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Feb 2021
Randomized Controlled TrialGene expression analysis of vastus medialis cells after tourniquet-induced ischemia during total knee arthroplasty: a randomized clinical trial.
Postoperative quadriceps muscle strength was lowered after tourniquet application during total knee arthroplasty (TKA). Furthermore, tourniquet application results in higher proteolytic activity within vastus medialis cells, without influence on the amount and function of mitochondria. The effects of the commonly utilized intraoperative tourniquet on gene expression within the human skeletal muscle cells are barely examined. The purpose of the present study was to analyze the gene expression within the skeletal muscle cells after tourniquet-induced ischemia to identify differential expressed genes (DEGs) and pathways. ⋯ Level I.
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Eur J Trauma Emerg Surg · Feb 2021
Quality of life after multiple trauma: results from a patient cohort treated in a certified trauma network.
Besides mortality, the patient-reported outcome (PRO) in survivors of multiple trauma is of increasing interest. So far, no data on patient-reported outcome measures (PROMs) after multiple trauma from an entire trauma network are available. Within this study, the course of the PRO over time and differences between level I and level II trauma centers within an entire trauma network was evaluated. ⋯ The consistently low EQ-5D index relative the reference population and the lack of a difference between level I and II centers suggest that improved strategies for polytrauma aftercare are called for.
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Eur J Trauma Emerg Surg · Feb 2021
Observational StudyDigital replantation/revascularization: predictive factors to microsurgery success-a single-center study.
Success rate in replantation/revascularization digital surgery is one of the challenges of reconstructive surgery. For this reason, investigating prognostic factors for survival and improvement of outcomes is highly relevant. The goal of this study was to establish predictive factors of survival in replantation/revascularization digital surgery. ⋯ Success rate in traumatic digital surgery is greater when revascularization surgery is performed, rather than replantation. Preoperative ischemia time, length of surgery, postoperative complications and re-intervention requirement are the factors that affect survival rate.
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Eur J Trauma Emerg Surg · Feb 2021
Multicenter Study Comparative StudyVenous thromboembolism (VTE) prophylaxis in severely injured patients: an international comparative assessment.
Venous thromboembolisms (VTE) are a major concern after acute survival from trauma. Variations in treatment protocols for trauma patients exist worldwide. This study analyzes the differences in the number of VTE events and the associated complications of thromboprophylaxis between two level I trauma populations utilizing varying treatment protocols. ⋯ A more early commencement protocol resulted in almost twice as much chemical prophylaxis being started within the first 48 h in comparison with a more delayed initiation of treatment. Interestingly, most episodes of VTE developed while receiving recommended prophylaxis. Early chemical thromboprophylaxis did not significantly increase the bleeding complications and it appears to be safe to start early.