Articles: trauma.
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Artif Cells Blood Substit Immobil Biotechnol · Jan 2010
ReviewAdvances in small gap sleeve bridging peripheral nerve injury.
Abstract: Nerve regeneration and re-innervation are usually difficult after peripheral nerve injury. Epineurium neurorrhaphy to recover the nerve continuity was the traditional choice of peripheral nerve mutilation without nerve defects, whereas the functional recovery was not quite satisfactory. In this article, the authors review the literature focused on peripheral nerve injury research and possible clinical application, including introducing peripheral nerve selective regeneration theory, small gap sleeve bridging nerve methodepineurium neurorrhaphy, kinds of biological conduit, and microenvironment research between nerve stumps.
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Head injury, severe acidosis, hypothermia, massive transfusion and hypoxia often complicate traumatic coagulopathy. First line investigations such as prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen level, platelet count and D-dimer levels help in the initial assessment of coagulopathy in a trauma victim. ⋯ Of the 48 patients studied, 38 (80%) had normal DIC scores upon admission and only 10 (20%) had mild DIC scores at the time of admission. The median Injury Severity Score was 34 and they did not correlate with DIC scores. Fibrinogen levels alone were significantly different, increased progressively (mean pre op, intra op and post op levels 518 +/- 31,582 +/- 35 and 643 +/- 27 respectively; P = 0.02) since the time of admission in these patients. All the other parameters remained unchanged. Further large scale prospective studies would be required to correlate elevated fibrinogen levels with the type of trauma or surgery.
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Multicenter Study
Wartime traumatic aneurysms: acute presentation, diagnosis, and multimodal treatment of 64 craniocervical arterial injuries.
Operation Iraqi Freedom has resulted in a significant number of closed and penetrating head injuries, and a consequence of both has been the accompanying neurovascular injuries. Here we review the largest reported population of patients with traumatic neurovascular disease and offer our experience with both endovascular and surgical management. ⋯ The management of traumatic vascular injury has evolved with technological advancement and the willingness of the neurosurgeon to intervene. Although open surgical intervention remains a viable solution, endovascular options are available and safe and can effectively temporize a patient while acute sequelae of serious head injury resolve.
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Traumatic asphyxia is probably much more common than the surgical literature shows and should always be kept in mind as a possible complication of injuries of the chest and abdomen. ⋯ Treatment for traumatic asphyxia is supportive, and patient recovery is related to the generally associated injuries. Traumatic asphyxia should always be kept in mind as a possible complication of injuries of the chest and abdomen.