European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Feb 2025
A novel scoring system for better management of small bowel obstruction.
Due to the lack of a comprehensive evaluation of the prognosis of small bowel obstruction (SBO), recent clinical strategies have remained subjective and controversial. The recognition of pretreatment risk factors and tailored treatment could improve SBO outcomes. ⋯ A novel TSC outcome model and RS system was constructed to comprehensively reflect the tailored treatment, surgical events and posttreatment recovery for SBO patients.
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Eur J Trauma Emerg Surg · Feb 2025
Masquelet technique including a multiperforated non-vascularized fibula graft for the reconstruction of massive post-traumatic bone defects in military practice.
The management of extensive bone defects presents a significant challenge for military orthopedic surgeons, especially in the context of a high intensity conflict or when patients are fully treated in the field. The objective was to evaluate the induced membrane technique (IMT) including a multiperforated non-vascularized fibular graft (NVFG) for the reconstruction of massive bone defects performed in both the ideal conditions of military trauma centers and the austere environment of forward surgical units. ⋯ In this small cohort, IMT including a multiperforated NVFG enabled successful reconstruction of massive bone defects in the femur, tibia, and humerus, even in the austere environment of forward surgical units, provided that prior infection control had been achieved.
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Eur J Trauma Emerg Surg · Jan 2025
Pelvic ring fracture and erectile dysfunction (PERFECD) - 3 year follow-up cross sectional study.
Pelvic ring fractures are known to be associated with complications associated with adjacent organ injuries, such as the urogenital tract (e.g. erectile dysfunction (ED), which are sometimes diagnosed in a delayed fashion. Therefore, we assessed the quality of life (QoL) and the rate of erectile dysfunction (ED) following pelvic ring fractures at a minimum of 3 years after pelvic ring injury. ⋯ Vertical shear fractures are associated with significantly lower quality of life compared to APC or LC fractures three years post-injury. The APC type of pelvic ring injury was identified as an independent risk factor for the development of erectile dysfunction (ED). Early screening and appropriate management should be initiated for patients with APC injuries to address and mitigate the risk of ED.
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Eur J Trauma Emerg Surg · Jan 2025
Assessing the role of chest CT in minor blunt trauma: evaluation of the NEXUS decision instrument across an expanded population.
To evaluate the NEXUS Chest CT ALL decision instrument (DI) in reducing unnecessary chest CT imaging in minor blunt trauma patients while preserving high sensitivity for detecting clinically meaningful injuries. Additionally, we examined the impact of delayed presentation, chronic disease, and anticoagulation/anti-aggregation medications on trauma outcomes. ⋯ The NEXUS Chest CT ALL DI significantly reduces unnecessary imaging while maintaining high diagnostic precision. A modified version enhances sensitivity, refining decision-making in emergency care. Integrating such decision tools, particularly in cases of minor trauma, is highly recommended to optimize resource use and improve patient outcomes.
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Eur J Trauma Emerg Surg · Jan 2025
Observational StudyExtracorporeal membrane oxygenation in trauma: a single-center retrospective observational study.
Globally, trauma is a leading cause of death in young adults. The use of extracorporeal membrane oxygenation (ECMO) in the trauma population remains controversial due to the limited published research. This study aimed to analyze 30-day survival of all the trauma ECMO patients at our center, with respect to injury severity score (ISS) and new injury severity score (NISS). ⋯ This study indicates that trauma patients may benefit from ECMO, independent of severity. Furthermore, our results support ECMO transport as feasible in trauma patients. We recommend larger multi-center studies to determine which trauma patients would have the greatest benefit of ECMO.