Articles: trauma.
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The decision in favor of surgery or nonoperative conservative treatment in blunt and penetrating abdominal trauma requires a precise diagnosis that is not always possible with imaging techniques, whereby there is great danger that an injury to the diaphragm or intestines may be overlooked. To avoid such oversights, indications for exploratory laparotomy have traditionally been generous, to the extent that up to 41% of exploratory laparotomies turn out to be nontherapeutic and could be, or could have been, avoided with laparoscopy. ⋯ Laparoscopy can be performed safely and effectively in stable patients with abdominal trauma. The most important advantages are reduction of the nontherapeutic laparotomy rate, morbidity, shortening of hospitalization, and cost-effectiveness. In the future, new developments in and the miniaturization of equipment can be expected to increase the use of minimally invasive techniques in abdominal trauma cases.
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Eur J Trauma Emerg S · Feb 2010
Trauma in a Teaching Hospital Outpost: Comprehensive Health Centre, Okoyong, Cross River State, Nigeria.
Road traffic injuries and other forms of trauma have become a major health problem worldwide, but Africa is the worst hit. This study was designed to evaluate the characteristics of trauma injuries in order to offer solutions for planning in terms of policy formulation and implementation. ⋯ Trauma was mainly due to road traffic injuries. The development of rural trauma systems and improvements in road and traffic infrastructure would reduce injury, morbidity, and mortality.
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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.
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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