European journal of trauma and emergency surgery : official publication of the European Trauma Society
-
Eur J Trauma Emerg Surg · Feb 2023
Randomized Controlled TrialLong-term outcomes after using retrievable vena cava filters in major trauma patients with contraindications to prophylactic anticoagulation.
To investigate the long-term outcomes of using vena cava filters to prevent symptomatic pulmonary embolism (PE) in major trauma patients who have contraindications to prophylactic anticoagulation. ⋯ Long-term complications related to retrievable filters were rare, and the cost of using filters to prevent symptomatic PE was acceptable when restricted to those who could not be anticoagulated within seven days of severe injury.
-
Eur J Trauma Emerg Surg · Feb 2023
Multicenter StudyAssociation between three prehospital thoracic decompression techniques by physicians and complications: a retrospective, multicentre study in adults.
We sought to compare the complication rates of prehospital needle decompression, finger thoracostomy and three tube thoracostomy systems (Argyle, Frontline kits and endotracheal tubes) and to determine if finger thoracostomy is associated with shorter prehospital scene times compared with tube thoracostomy. ⋯ There was no clear evidence for benefit associated with finger thoracostomy in reducing overall complication rates, infection rates or scene times, but the rate of recurrent tension physiology was significantly higher. Therefore, tube placement is recommended as soon as practicable after thoracic decompression.
-
Eur J Trauma Emerg Surg · Feb 2023
Regional anesthesia in trauma patients: a quality improvement study.
Traumatic injury is associated with severe pain that is often inadequately managed. Opioids remain the mainstay of pain management in this population because of their ease of use. However, opioids have significant side effects including nausea, delirium, and respiratory depression. Regional anesthesia has been demonstrated in the perioperative setting to provide superior analgesia with fewer side effects and a reduced length of stay. Similarly, regional anesthesia has been shown to improve morbidity for extremity fractures and dislocations when introduced early. ⋯ This quality improvement proof-of-principle study reveals the potential advantages for regional anesthesia, such as decreased emergency department use, opioid consumption, and pain severity. Further randomized trials are necessary, however, to describe a direct benefit from peripheral nerve blockade on reducing length of stay for trauma patients.
-
Eur J Trauma Emerg Surg · Feb 2023
Morphological risk factors for scaphoid fracture: a case-control study.
Most patients with a clinically suspected scaphoid fracture and normal initial radiograph are unnecessarily treated. Previously developed prediction rules using demographic and clinical risk are unable to accurately predict occult fractures. Adding other risk factors could enhance this. Therefore, we aim to explore if there are morphological risk factors of the wrist for sustaining a scaphoid fracture. ⋯ There was one complex wrist shape significantly associated with a scaphoid fracture. Since the association was weak and the shape is difficult to identify radiographs, we believe this morphological risk factor would not enhance identifying occult scaphoid fractures in the future.
-
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.