European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Jun 2022
Revisit of flap factors relating to partial necrosis of distally based sural flaps: an analysis of 435 cases in a single center.
Partial necrosis is an ongoing topic in regard to flap complications of the distally based sural (DBS) flap However, the factors influencing partial necrosis of the flap remain in debate. The aim of the present study is to further illuminate the flap-related risk factors and the effects of several technical improvements. ⋯ The top edge of the flap is an essential indicator for predicting the prognosis of the DBS flap. When the total length of the flap is more than 20 cm or the LWR of the flap more than 5:1, the partial necrosis rate will increase significantly. Various technical modifications can lower the top edge of the flap and reduce the LWR of the flap and width of the skin island, and thus improve the flap survival effectively.
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Eur J Trauma Emerg Surg · Jun 2022
Observational StudyImportance of firm isthmic fixation in high-energy induced subtrochanteric fracture of the femur: retrospective observational study in a level I trauma center.
This study aimed to report the surgical outcomes in patients with high-energy induced subtrochanteric fracture and determine the risk factors for nonunion using statistical analysis. ⋯ Level III, retrospective cohort study.
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Eur J Trauma Emerg Surg · Jun 2022
Bovine versus porcine acellular dermal matrix for abdominal wall herniorrhaphy or bridging.
The management of complicated ventral hernias (CVH), namely ventral hernias in actively or recently infected/contaminated operative fields, and open abdomens in which the native fascia cannot be primarily reapproximated, pose a surgical challenge. Fetal Bovine and Porcine Acellular Dermal Matrix (BADM and PADM) biologic meshes are being increasingly used in these scenarios. A comparison, however, of clinically relevant outcomes between the two is lacking. With this investigation, we aim to review and compare clinically relevant outcomes in patients that underwent abdominal wall herniorrhaphy with either BADM or PADM at a tertiary urban academic institution over a 5-year period. ⋯ Both BADM and PADM meshes perform well in CVH, with satisfactory recurrence rates, only slightly higher compared to traditional synthetic mesh repairs.
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Eur J Trauma Emerg Surg · Jun 2022
Causes of death among 93.637 hip fracture patients- data based on the Danish National Registry of causes of death.
Excess mortality among hip fracture patients is well documented. Less is known, however, about the causes of death in this group of patients, although existing literature suggests that bronchopneumonia and cardiovascular diseases constitute the leading causes of death. In this study, we investigated the causes of death in Danish hip fracture patients, who died within 30-days after sustaining a hip fracture, with a focus on differences in causes of death between men and women and between different age groups. Furthermore, the frequency of potentially preventable causes of death such as pneumonia, urinary tract infections and thromboembolic events was examined. ⋯ In this study, cardiovascular disease and pneumonia were overall the leading medical causes of death in patients dead within 30-days after sustaining a hip fracture. Apart from pneumonia, another potentially preventable infection in younger female hip fracture patients was urinary tract infections. Pulmonary embolism, another potentially preventable cause of death might be underreported in Danish death certificates.
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Eur J Trauma Emerg Surg · Jun 2022
Open chest selective aortic arch perfusion vs open cardiac massage as a means of perfusion during in exsanguination cardiac arrest: a comparison of coronary hemodynamics in swine.
To describe and compare the aortic-right atrial pressure (AoP-RAP) gradients and mean coronary perfusion pressures (CPPs) generated during open chest selective aortic arch perfusion (OCSAAP) with those generated during open cardiac massage (OCM) in hypovolemic swine. ⋯ OCSAAP generates favorable and potentially time-resistant pressure gradients when compared to those generated by OCM. Further investigation of the technique of OCSAAP is warranted, as it may have potential utility as a therapy during resuscitative thoracotomy (RT).