European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Necrotizing fasciitis is a life-threatening soft tissue infection characterized by a rapid spreading infection of the subcutaneous tissue and in particular the fascia. The management of infected tissues requires a rapid diagnosis, immediate aggressive surgical management and an extended debridement. In some cases early amputations of the affected tissues and maximum intensive care treatment, in case of sepsis, are required. Due to a rising number of cases we aimed to evaluate our patients in a retrospective review. ⋯ Surgical therapy is indicated if necrotizing fasciitis is suspected. Diabetes mellitus was a clinical predictor of limb amputation in patients with necrotizing fasciitis in our cohort. Aminopenicillin ± sulbactam in combination with clindamycin and/or metronidazole is recommended as initial calculated antibiotic treatment.
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Eur J Trauma Emerg Surg · Apr 2018
Assessment of normal forearm compartment pressures in a Nigerian population.
The forearm is prone to raised compartment pressure and it is the second most common site for compartment syndrome. The normal compartment pressure of the forearm should be known and serve as a benchmark for the diagnosis of acute and chronic compartment syndrome. This study was aimed to determine the normal compartment pressures of the forearm using a digital compartment pressure monitor. ⋯ The normal compartment pressure for forearm is 4.4 ± 1.6 mmHg and ranged from 1 to 8 mmHg from this study in our environment. This will serve as reference value when forearm compartment pressure is being measured.
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Eur J Trauma Emerg Surg · Apr 2018
Comparative StudyBiomechanical comparison of locked versus non-locked symphyseal plating of unstable pelvic ring injuries.
Locked symphyseal plates are utilized to provide higher levels of construct stiffness than non-locked plates. The current biomechanical study was performed to compare stiffness at the pubic symphysis between locked and non-locked plating systems. ⋯ Locked symphyseal plating systems can provide better stability than non-locked systems for anterior-posterior shear translation. More stability could potentially reduce the risk of failure of the plate or screws.
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Eur J Trauma Emerg Surg · Apr 2018
A retrospective evaluation of the Modified Alvarado Score for the diagnosis of acute appendicitis in HIV-infected patients.
The aim of this study was to evaluate and compare the diagnostic value of a Modified Alvarado Score (MAS) ≥7 for acute appendicitis in both Human Immunodeficiency Virus (HIV)-negative (HIVneg) and positive (HIVpos) patientcohorts. ⋯ A MAS ≥7 is a reliable predictor of acute appendicitis in HIVneg patients. In HIVpos patients, the MAS threshold required to accurately predict appendicitis is 8. The use of a MAS ≥7 in this group of patients will result in unnecessary surgical intervention.
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Eur J Trauma Emerg Surg · Apr 2018
Multidisciplinary team approach to traumatic spinal cord injuries: a single institution's quality improvement project.
A stepwise multidisciplinary team (MDT) approach to the injured trauma patient has been reported to have an overall benefit, with reduction in mortality and improved morbidity. Based on clinical experience, we hypothesized that implementation of a dedicated Spinal Cord Injury Service (SCIS) would impact outcomes of a patient specific population on the trauma service. ⋯ The application of an SCIS team in addition to the trauma service suggests that a structured coordinated approach can have an expected improvement in hospital outcomes and shorter length of stays. We believe that this clinical collaboration provides distinct specialist perspectives and, therefore, optimizes quality improvement. Level of evidence Epidemiologic study, level III.