European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Feb 2020
ReviewEffects of the application of a checklist during trauma resuscitations on ATLS adherence, team performance, and patient-related outcomes: a systematic review.
In this systematic literature review, the effects of the application of a checklist during in hospital resuscitation of trauma patients on adherence to the ATLS guidelines, trauma team performance, and patient-related outcomes were integrated. ⋯ The application of a checklist may improve ATLS adherence and workflow during trauma resuscitation. Current literature is insufficient to truly define the effect of the application of a checklist during trauma resuscitation on patient-related outcomes, although one study showed promising results as an improved chance of survival for the most severely injured patients was found.
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Eur J Trauma Emerg Surg · Feb 2020
Observational StudyThe impact of timing of antibiotics on in-hospital outcomes after major emergency abdominal surgery.
Patients undergoing major open emergency abdominal surgery experience high morbidity and mortality rates and often have sepsis at admission. The purpose of this study was to evaluate the association between antibiotic timing and in-hospital outcomes such as complications, need for reoperation, length of stay, and 30-day mortality. ⋯ Antibiotic administration more than 12 h from triage was associated with a significantly increased risk of postoperative complications, need for reoperation, 30-day mortality, and a prolonged length of stay, when compared to patients that received antibiotic treatment 0-6 h and 6-12 h after triage. Our data suggest that prophylactic antibiotics should be administered to all patients undergoing major open emergency abdominal surgery; however, the dose and duration cannot be concluded on the basis of our data and should be further examined.
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Eur J Trauma Emerg Surg · Feb 2020
Are injury admissions on weekends and weeknights different from weekday admissions?
To examine whether hours of a day and days of a week influence injury pattern, means of evacuation, and hospital resource utilization. ⋯ Injury pattern and resource utilization are related to time. Therefore, injury prevention and intervention efforts should account for hours of a day and days of a week, particularly in relation with age, gender, and ethnicity.
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Eur J Trauma Emerg Surg · Feb 2020
Displaced medial clavicle fractures: operative treatment with locking compression plate fixation.
Medial clavicle fractures are rare injuries and historically treated non-operatively. Displaced medial clavicle fractures, however, have a higher incidence of delayed- or non-union compared to non- displaced medial clavicle fractures and might benefit from operative treatment. We describe below a new technique for treating intra-articular fractures or extra-articular fractures with a small medial fragment using special locking plates and present the results of our operatively treated patients. ⋯ Operative treatment of displaced medial clavicle fractures with well-fitting 'small fragment' locking plates provides an excellent long-term functional outcome. Intra-articular fractures or extra-articular fractures with a small medial fragment can be treated with the radial (VA)-LCP™ Distal Humerus Plate.
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Eur J Trauma Emerg Surg · Feb 2020
Monotrauma is associated with enhanced remote inflammatory response and organ damage, while polytrauma intensifies both in porcine trauma model.
Severely injured patients experience substantial immunological stress upon traumatic insult. Next to the direct local tissue injury also other organs, which are not directly injured such as liver and lung, are frequently affected by a so-called remote organ damage (ROD) after trauma. Thus, we studied the inflammatory response of lung and liver either after isolated femur fracture as example for ROD, or after multiple trauma in a porcine polytrauma model. ⋯ Our data indicate that remote organ damage after MT notably in lungs was associated with an enhanced inflammatory response. Severe polytrauma substantially intensifies this response and organ damage in the underlying model.