European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Feb 2022
Simplified Kirschner‑wire-based dynamic external fixator for unstable proximal interphalangeal joint fractures.
Ligamentotaxis is a well-established treatment modality for treating challenging articular fractures. Many devices have been evolved to apply this principle to complex proximal interphalangeal joint (PIPJ) fractures. Although they gave satisfactory results, these devices were sometimes costly, complex and cumbersome. The aim of this study was to evaluate the short-term functional and radiological outcomes of treating complex intra-articular PIPJ fractures using a simplified, preloaded Kirschner‑wire (K‑wire)-based dynamic external fixator. ⋯ The used fixator technique is simple, reliable, available, reproducible, time-saving and cost-effective for managing complex PIPJ fractures while allowing early joint mobilization, which proven effective in achieving high satisfactory functional results.
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Eur J Trauma Emerg Surg · Feb 2022
Perfusion indices can predict early volume depletion in a blood donor model.
Blood donation from healthy donors is used experimental model that surrogates for class 1 hemorrhage in humans. We examined changes in the perfusion index (PI) and plethysmographic variability index (PVI) in healthy blood donors after donating a unit of blood, and we evaluated the usability of these indices in detecting blood loss volumes of less than 750 mL (class 1 hemorrhagic shock trauma patients). ⋯ We evaluated the perfusion indices in the early diagnosis of blood volume loss in patients admitted to the emergency department due to trauma. After the participants donated one unit of blood, we found that their PI decreased and PVI increased compared to the measurements before the blood donation. Considering that major bleeding starts in the very early stage as minor bleeding, it is essential for emergency physicians to recognize class 1 hemorrhagic shock patients. Further, non-invasive and straightforward procedures, such as measuring PI and PVI, can be particularly useful in identifying blood loss volumes of less than 750 mL.
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Eur J Trauma Emerg Surg · Feb 2022
Patterns of prevalence and contemporary clinical management strategies in complicated acute biliary calculous disease: an ESTES 'snapshot audit' of practice.
Acute complications of biliary calculi are common, morbid, and complex to manage. Variability exists in the techniques utilized to treat these conditions at an individual surgeon and unit level. ⋯ This first ESTES snapshot audit, a purely descriptive collaborative study, gives rich 'real world' insights into local variability in surgical practice as compared to international guidelines, and how this may impact upon outcomes. These granular data will serve to improve overall patient care as well as being hypothesis generating and inform areas needing future prospective study.
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Eur J Trauma Emerg Surg · Feb 2022
Mortality in relation to presence and type of oral antithrombotic agent among adult trauma patients: a single-center retrospective cohort study.
Oral anticoagulants (AC) and antiplatelet (AP) agents are increasingly prescribed to prevent and treat acute and chronic thrombotic conditions. The direct oral anticoagulants (DOAC), a newer class of AC, raise concerns in the trauma setting. Our study aims to compare the mortality rates and other outcomes among adult trauma patients based on pre-admission AC/AP status. ⋯ There was no evidence of increased mortality or blood transfusion requirement among trauma patients on DOAC, including head trauma patients. Further studies on head trauma and specific subgroups of DOAC are recommended.
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Eur J Trauma Emerg Surg · Feb 2022
Trauma-team-activation in Germany: how do emergency service professionals use the activation due to trauma mechanism? Results from a nationwide survey.
Trauma team activation (TTA) requires significant human and financial resources. The implemented German guidelines reduced the mortality of severe injured patients significantly over the last decade. Up to now there is no two-tier trauma team activation protocol in Germany. A two-tier TTA [often activated due to trauma mechanism (TM)] is thought to be a reasonable way to maintain patient safety while increasing cost efficiency. ⋯ IV, cross-sectional study.