European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Jun 2020
Comparative StudyEarly results after operatively versus non-operatively treated flail chest: a retrospective study focusing on outcome and complications.
Flail chest was traditionally treated non-operatively using mechanical ventilation and pain control. In order to reduce the occurrence of ventilation-associated complications and long-term disability, operative rib fixation is becoming a proven standard therapy for these patients. However, the consequences of the surgical complications may influence success rates negatively. The aim of this study was to compare the outcome of flail chest treatment by surgical rib fixation with non-operative treatment, with special focus on the impact of surgical complications. ⋯ Operative fixation of a flail chest in trauma patients results in a lower rate of pneumonia, less mechanical ventilation days and shorter hospital stay, compared with non-operative treatment, but at the cost of surgery-related complications requiring invasive solutions in some cases.
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Eur J Trauma Emerg Surg · Jun 2020
Comparative StudyComparison of intraoperative 2D vs. 3D imaging in open reduction and fixation of distal radius fractures.
In the volar plating of distal radius fractures, intraoperative three-dimensional (3D) imaging is designed to allow better judgment regarding screw and implant positioning compared with conventional intraoperative two-dimensional (2D) imaging. We evaluated the impact of these two imaging modalities on the rates of intraoperative revision and secondary surgery, as well as the need for implant removal during follow-up. ⋯ Compared with conventional 2D imaging, the use of intraoperative 3D imaging significantly increased the intraoperative revision rate and has the potential for positive long-term effects for lowering the risk of requiring an implant removal.
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Eur J Trauma Emerg Surg · Jun 2020
Evaluation of new quality indicators for the TraumaRegister DGU® using the systematic QUALIFY methodology.
The TraumaRegister DGU® (TR-DGU) of the German Trauma Society (Deutsche Gesellschaft für Unfallchirurgie, DGU) enables the participating hospitals to perform quality management. For that purpose, nine so-called audit filters have existed, since its foundation, which, inter alia, is listed in the Annual Report. The objective of this study effort is a revision of these quality indicators with the aim of developing pertinent new and reliable quality indicators for the management of severely injured patients. ⋯ Not all the key figures published for the management of severely injured patients are suitable for use as quality indicators. It remains to be seen whether the quality indicators identified by experts using the QUALIFY process will meet the requirements in practice. Prior to the implementation of the assessed quality indicators in standardized quality assurance programs, a scientific evaluation based on national data will be required.
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Eur J Trauma Emerg Surg · Jun 2020
Multicenter Study Comparative StudyThe Amsterdam Wrist Rules to reduce the need for radiography after a suspected distal radius fracture: an implementation study.
While most patients with wrist trauma are routinely referred for radiography, around 50% of these radiographs show no fracture. To avoid unnecessary radiographs, the Amsterdam Wrist Rules (AWR) have previously been developed and validated. The aim of the current study was to evaluate the effect of the implementation of the AWR at the Emergency Department (ED). ⋯ Implementation of the AWR safely reduces the amount of wrist radiographs in selected patients and consequently reducing the length of stay in the ED.
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Eur J Trauma Emerg Surg · Jun 2020
ReviewFacilitators and constrainers of civilian-military collaboration: the Swedish perspectives.
An increasing number of international and domestic armed conflicts, including terror attacks on civilians, along with constrained healthcare finance and resource limitation, has made a civilian-military collaboration (CMC) crucial. The purpose of this study was to identify facilitators and constrainers in CMC in a national perspective with a specific focus on medical aspects. ⋯ The current global and domestic security threats and challenges, make CMC critical and inevitable. However, there is a need for careful analysis of its consequences, impact, possibilities, and limitations to differentiate between our expectations and the current reality.