European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Feb 2025
ReviewStop the bleed " - Prehospital bleeding control in patients with multiple and/or severe injuries - A systematic review and clinical practice guideline - A systematic review and clinical practice guideline.
Our aim was to develop new evidence-based and consensus-based recommendations for bleeding control in patients with multiple and/or severe injuries in the prehospital setting. This guideline topic is part of the 2022 update of the German Guideline on the Treatment of Patients with Multiple and/or Severe Injuries. ⋯ Bleeding control is the basic objective of treatment. This can be easily justified based on empirical evidence. There is, however, a lack of reliable and high-quality studies that assess and compare methods for bleeding control in patients with multiple and/or severe injuries. The guideline provides reasonable and practical recommendations (although mostly with a low grade of recommendation) and also reveals several open research questions that can hopefully be answered when the guideline is revised again.
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Eur J Trauma Emerg Surg · Feb 2025
Masquelet technique including a multiperforated non-vascularized fibula graft for the reconstruction of massive post-traumatic bone defects in military practice.
The management of extensive bone defects presents a significant challenge for military orthopedic surgeons, especially in the context of a high intensity conflict or when patients are fully treated in the field. The objective was to evaluate the induced membrane technique (IMT) including a multiperforated non-vascularized fibular graft (NVFG) for the reconstruction of massive bone defects performed in both the ideal conditions of military trauma centers and the austere environment of forward surgical units. ⋯ In this small cohort, IMT including a multiperforated NVFG enabled successful reconstruction of massive bone defects in the femur, tibia, and humerus, even in the austere environment of forward surgical units, provided that prior infection control had been achieved.