European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · May 2024
The importance of predictive markers in incarcerated abdominal wall hernia.
Emergency abdominal wall hernia repairs play a significant role in general surgical emergencies. In such cases, the time taken to decide on surgery is crucial, as the situation may progress to necrosis, perforation, and organ resection due to strangulation following incarceration. To facilitate the early detection of this condition, studies have been conducted on various predictive markers, most of which are related to similar markers used in acute mesenteric ischemia. This study aims to assess the predictive significance of preoperative laboratory and imaging findings in incarcerated abdominal wall hernia with strangulation. ⋯ In cases of abdominal wall hernia operations due to incarceration, bowel and/or intra-abdominal organ resections related to strangulation can lead to significant morbidity and mortality. Beyond the imaging methods available for preoperative assessment, high levels of laboratory parameters, including Lactate, WBC, Neutrophil, and NLR ratio, may primarily indicate the need for bowel resection, considering that omental resection is associated with lower morbidity and mortality compared to bowel resection, elevated levels of monocytes may primarily indicate the requirement for omental resection in emergency abdominal wall hernia surgery. We recommend that this be prioritized in emergency surgery to prevent complications such as bowel perforation and sepsis and improve clinical outcomes. The surgeon is advised to keep this in mind.
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Eur J Trauma Emerg Surg · May 2024
The dynamic locking blade plate: seven-year follow-up results of 389 patients with a femoral neck fracture.
This study aimed to investigate the long-term outcomes of patients with a femoral neck fracture (FNF), treated with the Dynamic Locking Blade Plate (DLBP). ⋯ This study is the first long-term follow-up study on the outcome of the DLBP. The DLBP demonstrated positive long-term results in the treatment of FNF.
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Eur J Trauma Emerg Surg · May 2024
Variation in care and outcome for fragile hip fracture patients: a European multicentre study benchmarking fulfilment of established quality indicators.
Despite the availability of clinical guidelines for hip fracture patients, adherence to these guidelines is challenging, potentially resulting in suboptimal patient care. The goal of this study was (1) to evaluate and benchmark the adherence to recently established quality indicators (QIs), and (2) to study clinical outcomes, in fragile hip fracture patients from different European countries. ⋯ The present study shows large variation in the care for fragile patients with hip fractures indicating room for improvement. Therefore, hospitals should invest in benchmarking and knowledge-sharing. Large quality improvement initiatives with longitudinal follow up of both process and outcome indicators should be initiated.
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Eur J Trauma Emerg Surg · May 2024
ReviewTranslating training to medical practice in trauma care, a literature review.
Trauma, a global health challenge, remains a significant cause of mortality despite advances in trauma management. The establishment of trauma teams has revolutionized care in trauma resuscitation. The training of these teams is designed to promote self-trust and empower trainees in trauma care, enhance performance, and improve patient outcomes. ⋯ In this review, we have examined relevant literature data on standard teaching programs, the educational delivery methods used, and their impact on adult trauma patients' outcomes and trained team-related outcomes. While most studies indicate improved trained team performance, they consistently show no improvement in patient-specific outcomes such as mortality, morbidity, and length of stay. However, data hints at optimal educational delivery and the role that technology may play in the future of trauma training development.
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Eur J Trauma Emerg Surg · May 2024
Treatment of unstable forearm fractures at the metaphyseal-diaphyseal junction in children: antegrade ESIN vs. transepiphyseal intramedullary K-wire fixation.
Treatment of unstable forearm fractures in the metaphyseal-diaphyseal junction (MDJ) zone is still a matter of debate. Major drawbacks of all types of fixations include either invasiveness, technical impracticality, or lack of acceptance by patients. This study reports results after antegrade ESIN (a-ESIN) compared to transepiphyseal intramedullary K-wire (TIK) for unstable MDJ forearm fractures. ⋯ Both a-ESIN and TIK are minimally invasive procedures that are technically easy to perform. Both methods are safe and lead to a complete restoration of the forearm's range of motion. The decisive advantage of a-ESIN is the possibility of postoperative immobilization-free rehabilitation.