Helvetica chirurgica acta
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Helvetica chirurgica acta · Jul 1994
[Results of surgery in gunshot and stab injuries of the trunk].
Between 1981 and 1990, 105 patients suffering from gunshot and stab wounds were admitted to the Department of Surgery of Zürich University Hospital. There were 17 female and 88 male patients aged 16-74 years (average 31 years) whose charts were studied retrospectively. 44 patients demonstrated gunshot injuries, while 60 suffered from stabwounds and 1 patient had both. The injuries were the result of a crime in 59, a suicide in 33 and an accident in 11 cases. ⋯ Overall mortality amounted to 14.3% (n = 15). Patients with gunshot wounds had a significantly higher mortality rate (p < 0.0005). Debridement and selective closure of the wounds (n = 25) did not result in a higher rate of abscess formation than open treatment (n = 17).
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Helvetica chirurgica acta · Jul 1994
Case Reports[Central liver lesion by a high velocity bullet with massive hemorrhage: what is the solution?].
The management of severe hepatic trauma may represent a challenge in the presence of haemodynamic instability, coagulopathy, hypothermia or metabolic failure. Moreover, the choice of treatment should consider the prevention of complications. The omentum has many advantages including hemostasis, infection preventing, viability and adaptability to reconstruction as a space filler. ⋯ The viable omentum was placed through the hepatic hole and fixed posteriorly to the skin. The postoperative period was uneventful, excluding the development of a biliary fistula which resolved after external drainage. We conclude that omental packing is a valid solution when dealing with penetrating liver injury.
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Helvetica chirurgica acta · Jul 1994
[The importance of surgical assistants from the viewpoint of the heads of surgery].
60 heads of surgical units of non-university hospitals in Switzerland were questioned about their opinion about their assistants. The questionnaire was divided into: general data about hospital size and number of assistants, employment criteria, further education, operative activities and working hours of assistants. The answers are representative for the situation in non-university hospitals in Switzerland.
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Helvetica chirurgica acta · Jul 1994
Case Reports[Isolated traumatic dislocation of the head of the fibula].
Dislocation of the proximal tibiofibular joint is a rare injury. Diagnosis is initially often missed. Physical examination and radiographic findings of a 22-year-old football player are reported. Classification and therapeutic options are discussed.
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Helvetica chirurgica acta · Apr 1994
Case Reports[Secondary peritonitis after negative computerized tomography in blunt abdominal trauma].
Diagnostic peritoneal lavage has widely been replaced by emergency sonography in the evaluation of blunt abdominal trauma. CT is generally performed in cases without major hemodynamic instability in order to define non-operative treatment of injuries of the parenchymatous organs or to precise the extension of retroperitoneal, spinal and pelvic lesions. ⋯ Despite discrete clinical signs, these lesions were only diagnosed at the stage of obvious secondary peritonitis. These cases should remind us the limits of CT in the evaluation of abdominal visceral lesions in blunt trauma.