European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Apr 2020
ReviewElectrical stimulation in bone tissue engineering treatments.
Electrical stimulation (EStim) has been shown to promote bone healing and regeneration both in animal experiments and clinical treatments. Therefore, incorporating EStim into promising new bone tissue engineering (BTE) therapies is a logical next step. ⋯ In this review, we discuss results of recent in vitro and in vivo research focused on using EStim to promote bone healing and regeneration and consider possible strategies for its application to improve outcomes in BTE treatments. Technical aspects of exposing cells and tissues to EStim in in vitro and in vivo model systems are also discussed.
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Eur J Trauma Emerg Surg · Apr 2020
ReviewThe evolution of trauma care in the Netherlands over 20 years.
In 1999 an inclusive trauma system was initiated in the Netherlands and a nationwide trauma registry, including all admitted trauma patients to every hospital, was started. The Dutch trauma system is run by trauma surgeons who treat both the truncal (visceral) and extremity injuries (fractures). ⋯ Further centralisation to a limited number of level 1 trauma centres in the Netherlands is necessary to consolidate experience and knowledge for the trauma surgeon. The future trauma surgeon, as specialist for injured patients, should be able to provide the vast majority of trauma care in this system. For the remaining part, intramural, regional and national collaboration is essential.
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Eur J Trauma Emerg Surg · Apr 2020
ReviewElectrical stimulation-based bone fracture treatment, if it works so well why do not more surgeons use it?
Electrical stimulation (EStim) has been proven to promote bone healing in experimental settings and has been used clinically for many years and yet it has not become a mainstream clinical treatment. ⋯ Despite their awareness of EStim's pro-fracture healing effects few orthopedic surgeons use it in their patients. Our review of the literature and survey indicate that this is due to confusion in the literature due to the great variation in methods reported, and the inconsistent results associated with this treatment approach. In spite of this surgeons seem to be open to using this treatment if advancements in the technology were able to provide an easy to use, cost-effective method to deliver EStim in their fracture patients.
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Eur J Trauma Emerg Surg · Apr 2020
Observational StudyCan cortisol levels predict the severity of acute whiplash-associated disorders?
The exact underlying mechanism of whiplash-associated disorders still remains obscure. Central sensitization of the brain to painful stimulus and disturbances in the hypothalamic-pituitary-adrenal axis has been suggested to contribute to the development of whiplash-associated disorders. Although cortisol is a well-known factor in the acute stress response and its effects on chronic pain sensation were studied, information is lacking regarding the relation between acute phase cortisol concentrations and the intensity of whiplash-associated disorders. The aim of this prospective observational study was to investigate the relationship between acute serum cortisol concentrations and the severity of whiplash-associated disorders. ⋯ The study supports the possibility that cortisol plays a role in the development of whiplash-associated disorders. Low or relatively low cortisol concentrations might be associated with more severe forms of the disorder.
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Eur J Trauma Emerg Surg · Apr 2020
Risk factors for potential pulmonary embolism in the patients with deep venous thrombosis: a retrospective study.
The risk factors for the detachment of big thrombi from the vessel wall in patients with deep venous thrombosis (DVT) are still not clear, which are potential risks for pulmonary embolism (PE). This study was aimed to identify the risk factors for big thrombi detaching from the vessel wall in the patients with lower extremity DVT and to identify the role of the lower limb immobilization. ⋯ The results suggested that major surgery and mobile lower limb were independent risk factors for potential thrombus of PE in patients with DVT. Immobilization of lower limb might play a protective role in preventing big thrombi from detaching from the vessel wall in patients with DVT.