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
Diagnosis of single adhesive bands versus matted adhesions in small bowel obstructions: a radiological predictive score.
The objective was to develop a radiological score obtained from multi-detector computed tomography (MDCT) to differentiate between single band adhesion (SBA) and matted adhesions (MA) as the etiology of small bowel obstruction (SBO). ⋯ The present score, validated in a different population, could be a significant tool in the decision for surgical management.
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Eur J Trauma Emerg Surg · Feb 2022
Endovascular repair is a feasible option for superficial femoral artery injuries: a comparative effectiveness analysis.
To compare outcomes between open (OR) and endovascular repair following superficial femoral artery (SFA) injuries. ⋯ Endovascular management is not inferior to OR following SFA injuries and both carry a low amputation rate. OR is associated with a higher fasciotomy rate. Endovascular repair should be considered when technically feasible.
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Eur J Trauma Emerg Surg · Feb 2022
Investigation of the relationship of the number, localization, and displacement of rib fractures with intrathoracic structures and abdominal solid organ complications using computed tomography.
This study aimed at evaluating the fracture properties, intrathoracic structures, and abdominal solid organ complications in patients with traumatic rib fractures. ⋯ The presence of a displaced rib fracture is a strong predictor of intrathoracic complications. A more careful intrathoracic evaluation of rib fractures with more than 2 mm displacement will contribute to patient management.
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Eur J Trauma Emerg Surg · Feb 2022
A feasibility study of partial REBOA data in a high-volume trauma center.
Resuscitative endovascular balloon occlusion of the aorta (REBOA) is used to temporize patients with infradiaphragmatic hemorrhage. Current guidelines advise < 30 min, to avoid ischemia/ reperfusion injury, whenever possible. The technique of partial REBOA (P-REBOA) has been developed to minimize the effects of distal ischemia. This study presents our clinical experience with P-REBOA, comparing outcomes to complete occlusion (C-REBOA). ⋯ P-REBOA can be delivered in a clinical setting, but is not currently associated with improved survival in prolonged occlusion. In survivors, there is a trend toward lower organ support needs, suggesting that the technique might help to mitigate ischemic organ injury. More clinical data are needed to clarify the benefit of partial occlusion REBOA.
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Eur J Trauma Emerg Surg · Feb 2022
Comparison of surgical fixation and non-operative management in patients with traumatic sternum fracture.
The incidence of sternal fractures in blunt trauma patients lies between 3 and 7%. The role, timing and indications for surgical management are not well delineated and remain controversial for patients undergoing surgical stabilization of sternum fracture (SSSF). We sought to identify the national rate of SSSF in patients with a sternum fracture hypothesizing patients undergoing SSSF will have a decreased rate of mortality and complications. ⋯ Just over 1% of patients with sternum fracture underwent SSSF in a national analysis. Patients undergoing SSSF had an increased LOS and similar rate of all measured pulmonary complications, however a lower mortality rate compared to patients managed non-operatively.