European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Feb 2023
Pulsatile lavage systems and their potential to penetrate soft tissue.
In orthopedic and trauma surgery, pulsatile lavage systems are used to clean soft tissue. This may be necessary in septic surgeries or in case of contaminated wounds after trauma. Positive features such as reduction of bacterial contamination and removal of foreign particles are counterbalanced by negative aspects such as bacterial seeding in deeper tissue layers, damage to various tissues and even cases of air embolism. ⋯ In this study, we found that higher impact pressure leads to deeper penetration and therefore bacteria are likely to be transferred to deeper tissue layers.
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Eur J Trauma Emerg Surg · Feb 2023
Association between hypotension and myocardial injury in patients with severe trauma.
During resuscitation of patients with severe trauma, guidelines recommend permissive hypotension prior to surgical bleeding control. However, hypotension may be associated with reduced organ perfusion and multiple organ dysfunction, e.g. myocardial injury. The association between hypotension and myocardial injury in trauma patients is underexplored. We hypothesized that hypotension is associated with myocardial injury in this population. ⋯ The duration of hypotension during resuscitation period is independently associated with the incidence of myocardial injury in patients with severe trauma.
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Eur J Trauma Emerg Surg · Feb 2023
Observational StudySurgical management of acute appendicitis during the European COVID-19 second wave: safe and effective.
The COVID-19 (SARS-CoV-2) pandemic drove acute care surgeons to pivot from long established practice patterns. Early safety concerns regarding increased postoperative complication risk in those with active COVID infection promoted antibiotic-driven non-operative therapy for select conditions ahead of an evidence-base. Our study assesses whether active or recent SARS-CoV-2 positivity increases hospital length of stay (LOS) or postoperative complications following appendectomy. ⋯ During sequential SARS-CoV-2 infection waves, neither active nor prior SARS-CoV-2 infection was associated with prolonged hospital LOS or postoperative complication. Despite early concerns regarding postoperative safety and outcome during active SARS-CoV-2 infection, no such association was noted for those with appendicitis who underwent operative management.
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Eur J Trauma Emerg Surg · Feb 2023
Area of the plateau depression and higher age predict post-operative subsidence in split-depression lateral tibial fracture.
The aim of this study was to determine factors that affect post-operative subsidence in split-depression lateral plateau tibial fracture (OTA/AO 41B3.1) which was treated with raft construct through a locking plate. ⋯ Age and depressed lateral plateau area (DPA) in split-depression lateral plateau tibial fracture treated with raft construct through a locking plate are risk factors for post-operative subsidence greater than 2 mm.
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Eur J Trauma Emerg Surg · Feb 2023
Posterior acetabular wall morphology is an independent risk factor that affects the occurrence of acetabular wall fracture in patients with traumatic, posterior hip dislocation.
Smaller posterior acetabular walls have been shown to independently influence the risk for bipolar hip dislocation. We asked whether differences would also be observed in patients with traumatic posterior hip dislocation with and without posterior wall fractures. ⋯ Both posterior acetabular sector angle and posterior wall angle are independent factors determining the posterior wall fracture morphology in patients with traumatic posterior hip dislocation. Age and the observed trauma mechanism did not differentiate between traumatic posterior hip dislocations with and without posterior wall fractures.