Injury
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Airway trauma is a life threatening condition requiring prompt diagnosis and management. We present our experience focusing on the diagnosis, airway management and treatment. ⋯ Surgical primary repair represents the treatment of choice in airway injuries with the approach depending on the specific site of the lesion. Therefore we consider valuable the division of the tracheobronchial tree in 4 zones.
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Multicenter Study
Missed injuries during the initial assessment in a cohort of 1124 level-1 trauma patients.
Despite the presence of diagnostic guidelines for the initial evaluation in trauma, the reported incidence of missed injuries is considerable. The aim of this study was to assess the missed injuries in a large cohort of trauma patients originating from two European Level-1 trauma centres. ⋯ Despite guidelines to avoid missed injuries, this problem is hard to prevent, especially in the severely injured. The present study showed that the rate of missed injuries was comparable with the literature and their consequences not severe. A high index of suspicion remains warranted, especially in multitrauma patients.
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Major liver trauma in polytraumatic patients accounts for significant morbidity and mortality. We aimed to assess prognostic factors for morbidity and mortality in patients with severe liver trauma undergoing perihepatic packing. ⋯ Revised Trauma Score, haemodynamic instability, blood pH and BE are important prognostic factors influencing morbidity and mortality in polytrauma patients with grade IV/V liver injury. Furthermore, fast and effective surgical damage control procedure with perihepatic packing, followed by early ICU admission is associated with lower complication rate and shorter ICU stays in this patient population.
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To examine injuries sustained in noncombat motor vehicle accidents (MVAs) during Operation Iraqi Freedom by injury type, site, and severity. ⋯ This analysis provides a thorough overview of injuries incurred in nonbattle MVAs in the combat environment. Future research should combine injury data with accident reports to elucidate areas for improvements in vehicle safety.