European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Dec 2021
Do not drink and lyse: alcohol intoxication increases fibrinolysis shutdown in injured patients.
High alcohol consumption has been associated with decreased fibrinolysis and enhanced thrombosis risk in cardiovascular disease. In trauma, alcohol has been associated with poor clot formation; however, its effect on fibrinolysis has not been fully investigated. We assessed the association of blood alcohol levels and fibrinolysis in trauma activation patients. ⋯ In the injured patient, high blood alcohol levels are associated with increased incidence of fibrinolysis shutdown. This finding has implications for postinjury hemostatic resuscitation as these patients may be harmed by anti-fibrinolytics. Further research is needed to assess whether the association with fibrinolysis is modified by the chronicity and type of alcohol consumed and whether anti-fibrinolytic therapy in intoxicated patients produces adverse effects.
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Eur J Trauma Emerg Surg · Dec 2021
Surgical intervention for blunt bowel and mesenteric injury: indications and time intervals.
Decision making in management of blunt bowel and mesenteric injury (BBMI) is difficult. This study aimed to identify indicators for laparotomy and appropriate time intervals to surgery. ⋯ Early surgical intervention is essential in cases of hemodynamically unstable BBMI and bowel perforation with free air; nevertheless, it is associated with high mortality. We suggest that prompt transport along with early intervention could significantly lessen mortality.
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Eur J Trauma Emerg Surg · Dec 2021
Necessity of acceptable radiologic alignment by preoperative closed reduction for unstable distal radius fractures treated with volar locking plates.
The purpose of this study was to demonstrate the necessity of achieving acceptable radiographic alignment by preoperative closed reduction in unstable distal radius fractures (DRFs) to improve preoperative pain and obtain satisfactory outcomes after surgery. ⋯ Our results suggest that obtaining acceptable radiologic alignment by closed reduction is not necessary for patients who make an informed decision to undergo volar plating for unstable DRFs.
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Eur J Trauma Emerg Surg · Dec 2021
A public-private collaborative model for a trauma program implementation: findings from a prospective trauma registry at 14 hospitals in Buenos Aires, Argentina.
Trauma is a leading cause of mortality and comprises an important cause of functional impairment among young people worldwide. The trauma registry (TR) is an integral component of modern comprehensive trauma care systems. Nevertheless, TRs have not been yet established in most developing countries. The objective of this study was to summarize the challenges, results, and lessons learned from a trauma program including initial results from a TR at tertiary-care public hospitals of Buenos Aires, Argentina. ⋯ The implementation of a trauma program within a public-private collaborative program in a resource-limited environment is feasible. The hospital-based TR can be used as a tool for injury surveillance, monitoring of the quality of trauma care, development of a trauma system, and to guide public health policies.
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Eur J Trauma Emerg Surg · Dec 2021
Review Meta AnalysisComparison of the feasibility of 3D printing technology in the treatment of pelvic fractures: a systematic review and meta-analysis of randomized controlled trials and prospective comparative studies.
The objective of this meta-analysis was to assess the influence of 3D printing technology on the open reduction and internal fixation (ORIF) of pelvic fractures from current randomized controlled trials and prospective comparative studies. ⋯ The 3D group showed shorter operation time, less intraoperative blood loss, less complications, better quality of fracture reduction and fast function recovery. Therefore, compared with conventional ORIF, ORIF assisted by 3D printing technology should be a more appropriate treatment of pelvic fractures.