Polski przeglad chirurgiczny
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Cervical spine injury (CSI) in octogenarians continues to carry a high morbidity and mortality rate. The incidence of CSI among individuals who are below the age of 80 is declining, whereas the incidence of CSI for those 80 years and above is rising. The aim of the study was to evaluate outcomes of cervical spine injuries in octogenarians caused by different mechanisms: motor vehicle accidents, compared to a fall. ⋯ Conclusions. Cervical spine injury in octogenarians carries a high mortality regardless of mechanism. Elderly patients who suffer cervical spine injuries in motor vehicle accidents have a lower SBP, a higher ISS and are nearly twice as likely to die as those who were injured in a fall.
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The skin is the largest organ of the human body consisting of several layers possessing different properties and performing different physiological functions. The loss of skin integrity caused by a trauma or disease may provoke acute physiological and immune disorders that may even be fatal. The following properties are primarily taken into account when choosing the appropriate burn wound dressing: support of the epithelialisation process, pain and patient discomfort reduction, and treatment costs. THE AIM OF THE STUDY was to assess the usefulness of Suprathel in the treatment of partial-thickness burns and frostbites and Lyell's syndrome and to determine the preferable time of Suprathel application to the wound. ⋯ Suprathel is a good dressing that can perform the function of a temporary epidermal substitute in partial-thickness burns and frostbites and in Lyell's syndrome. The dressing should be applied within 24 hours of injury, when there is the least exudate from the wound and the wound is not infected. Therapeutic effectiveness of Suprathel decreases along with a delay of its application to the burn wound and with increasing burn depth.
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Comparative Study Controlled Clinical Trial
Implementation of the fast track surgery in patients undergoing the colonic resection: own experience.
A perioperative care in the colorectal surgery has been considerably changed recently. The fast track surgery decreases complications rate, shortens length of stay, improves quality of life and leads to cost reduction. It is achieved by: resignation of a mechanical bowel preparation before and a nasogastric tube insertion after operation, optimal pain and intravenous fluid management, an early rehabilitation, enteral nutrition and removal of a vesical catheter and abdominal drain if used. ⋯ There were no statistical difference in mortality, morbidity neither reoperation rate between two groups. Conclusion. The fast track surgery is a safe strategy and may improve a perioperative care.
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Femoral shaft fracture in child is a disabling injury. Different methods of treatment can be used for femoral shaft fracture and depends on patient condition. THE AIM OF THE STUDY was to evaluate lower limb discrepancy following different method of treatment and possible related factors especially type of fractures. ⋯ Type of fracture, only, has a role in screw and plate fixation group and this is may be due to the differences between A1 and A3 fractures. Most of the changes were seen in the range of 60 through 120 months of age. Most of the changes were in the range +10 to +20 mm.
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Practice Guideline
Recommendations for the management of trauma or surgery-related massive blood loss.
Exsanguination is an underestimated cause of treatment failures in patients with severe trauma or undergoing surgery. In some patients the primary dysfunction of blood clot formation is a direct cause of a massive blood loss. Patients without previous coagulation disorders are at risk of coagulopathy following intraoperative or post-traumatic bleeding, where the local haemostasis does not warrant bleeding cessation. ⋯ Multidisciplinary therapeutic management of bleeding patients is associated with employment of appropriate treatment methods to achieve the best possible outcome. Factors influencing the development of coagulopathy, the methods of diagnosis and proposed techniques of treatment may facilitate therapeutic decisions in bleeding patients requiring massive transfusion of blood components.