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
Review Meta AnalysisAlginate scaffolds improve functional recovery after spinal cord injury.
In this systematic review and meta-analysis, the use of alginate for the repair of the damaged spinal cord was investigated. ⋯ These findings suggest that alginate is an efficient scaffold for functional recovery and even a much better scaffold for drug/cell delivery after SCI.
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Eur J Trauma Emerg Surg · Jun 2022
Geriatric patients with dementia show increased mortality and lack of functional recovery after hip fracture treated with hemiprosthesis.
Operative timing, perioperative management and postoperative rehabilitation are rising challenges in orthopedic geriatric trauma. The aim of this study was to determine the outcome of patients with dementia or with a high number of comorbidities treated with hemiprosthesis after hip fracture. Literature regarding patients with high comorbidities is scarce, leaving nothing but endoprosthetic treatment for even the sickest, immobile patients. ⋯ Patients classified ASA IV and V or suffering dementia show poor outcome after hip fracture treated with hemiprosthesis. Multidisciplinary approaches including surgeons, geriatricians, physiotherapists and psychiatrists are needed to improve the outcome of these patients. Especially in a subgroup of patients, where no mobilization is expected, alternative treatment options may be considered.
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Eur J Trauma Emerg Surg · Jun 2022
Multicenter StudyThe effect of Covid-19 on the willingness to use video consultations among orthopedic and trauma outpatients: a multi-center survey in 1400 outpatients.
Due to the Covid-19 pandemic, making more use of remote medical solutions has been advertised. The purpose of this study was to assess the willingness of orthopedic trauma patients to conduct an online video consultation (OVC) during the coronavirus pandemic compared to before. ⋯ The majority of the assessed outpatients would use an OVC. Fear of infections have increased, and direct physical contact is less important since the Covid-19 pandemic, but have not increased the disposition for an OVC significantly.
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Eur J Trauma Emerg Surg · Jun 2022
ReviewExtracellular vesicles as mediators and markers of acute organ injury: current concepts.
Due to the continued high incidence and mortality rate worldwide, there is a need to develop new strategies for the quick, precise, and valuable recognition of presenting injury pattern in traumatized and poly-traumatized patients. Extracellular vesicles (EVs) have been shown to facilitate intercellular communication processes between cells in close proximity as well as distant cells in healthy and disease organisms. miRNAs and proteins transferred by EVs play biological roles in maintaining normal organ structure and function under physiological conditions. ⋯ In this review, we discuss the general characteristics and technical aspects of EVs isolation and characterization. We discuss results of recent in vitro, in vivo, and patients study describing the role of EVs in different inflammatory diseases and traumatic organ injuries. miRNAs and protein signature of EVs found in patients with acute organ injury are also debated.
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Eur J Trauma Emerg Surg · Jun 2022
ReviewMeasuring functional outcomes in major trauma: can we do better?
There is relatively limited large scale, long-term unified evidence to describe how quality of life (QoL) and functional outcomes are affected after polytrauma. The aim of this study is to review validated measures available to assess QoL and functional outcomes and make recommendations on how best to assess patents after major trauma. ⋯ To achieve optimal outcomes for patients with polytrauma, we will need to focus on what matters most to them, including their needs (and unmet needs). The use of appropriate PROMs allows evaluation and improvement in the care we can offer. Transformative effects have been noted in cases where they have been used to guide treatment, and if embedded as part of the wider system, it should lead to better overall outcomes. Accordingly, we have made recommendations to this effect. It is time to seize the day, bring these measures even further into our routine practice, and be part of shaping the future.