European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Jun 2019
Platelet-rich plasma as an additional therapeutic option for infected wounds with multi-drug resistant bacteria: in vitro antibacterial activity study.
Infected wounds, such as diabetic foot infections, are mostly polymicrobial and microorganisms have high resistance rates to antimicrobials. Infected wounds in diabetic patients have high cost, morbidity, and mortality rates. Based on these facts, there is a need for supportive localized treatment options such as platelet-rich plasma (PRP) implementations. Demonstrating the in vitro antimicrobial effect, our aim was to lead up to clinical trials of localized PRP implementations in infected wounds such as diabetic foot infections. In this study, we aimed to demonstrate the in vitro antibacterial activity of PRP against methicilin-resistant Staphylococcus aureus (MRSA) and three more multi-drug resistant bacteria species that are important and hard-to-treat in wound infections. ⋯ Emerging PRP and other platelet-derived products seem to be promising alternative tools besides antibiotic treatment, debridement, negative pressure wound therapy, hyperbaric oxygen therapy, and other treatment options for treating diabetic foot infections.
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Eur J Trauma Emerg Surg · Jun 2019
Blunt traumatic injury during pregnancy: a descriptive analysis from a level 1 trauma center.
The precise incidence of trauma in pregnancy is not well-known, but trauma is estimated to complicate nearly 1 in 12 pregnancies and it is the leading non-obstetrical cause of maternal death. ⋯ Trauma during pregnancy is not an uncommon event particularly in the traffic-related crashes. As it is a complex condition for trauma surgeons and obstetrician, an appropriate management protocol and multidisciplinary team are needed to improve the outcome and save lives of both the mother and fetus.
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Eur J Trauma Emerg Surg · Jun 2019
ReviewPre-peritoneal pelvic packing for the management of life-threatening pelvic fractures.
Pre-peritoneal pelvic packing (PPP) is a technique used for treating pelvic hemorrhage in patients with pelvic fractures and hemodynamic instability after a high-energy trauma representing a life-threatening situation. The aim of this study was to perform a comprehensive review of the literature. ⋯ PPP is a surgical approach used in life-threatening situations due to pelvic fracture with high risk of death for exsanguination. Performed expediently, good results can be obtained with a decrease in the need for blood products, improved systolic blood pressure, and a decrease in mortality rates overall. This makes PPP an important life-saving tool.
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Eur J Trauma Emerg Surg · Jun 2019
ReviewTraumatic injuries to the pregnant patient: a critical literature review.
Trauma during pregnancy is the leading non-obstetrical cause of maternal death and a significant public health burden. This study reviews the most common causes of trauma during pregnancy, morbidity, and mortality, and the impact upon perinatal outcomes associated with trauma, providing a management approach to pregnant trauma patients. ⋯ Trauma in pregnant women is associated with high rates of adverse maternal and neonatal outcomes. Knowledge of the mechanism of injury is important to identify the potential injuries and the complexity of the management of these patients. As in all traumatic events, prevention is of paramount importance.
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Eur J Trauma Emerg Surg · Jun 2019
Trauma patients centralization for the mechanism of trauma: old questions without answers.
Centralization of trauma patients has become the standard of care. Unfortunately, overtriage can overcome the capability of Trauma Centres. This study aims to analyse the association of different mechanisms of injury with severe or major trauma defined as Injury Severity Score (ISS) greater than 15 and an estimation of overtriage upon our Trauma Centre. ⋯ Significant association with major trauma was demonstrated in the multivariate analysis of different mechanisms of trauma in patients triaged only for dynamics. A revision of our field triage protocol with a prospective validation is needed to improve overtriage that is above the suggested limits.