Injury
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Rotational thromboelastometry (ROTEM(®)) relies on citrated blood samples, which are regarded as biologically stable for up to 4 h after venepuncture. However, this recommendation is based on data from normal volunteers. The aim of this study was to evaluate possible temporal changes in the coagulability of blood samples from coagulopathic trauma patients. ⋯ Repeated ROTEM(®) EXTEM analysis of citrated samples from coagulopathic trauma patients shows a spontaneous improvement in coagulability with time. The absence of parallel changes on FIBTEM analysis suggests that this effect may be due to a change in platelet function.
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Multicenter Study Comparative Study
Comparative analysis of trends in paediatric trauma outcomes in New South Wales, Australia.
Paediatric trauma centres seek to optimise the care of injured children. Trends in state-wide paediatric care and outcomes have not been examined in detail in Australia. This study examines temporal trends in paediatric trauma outcomes and factors influencing survival and length of stay. ⋯ The number of severe injury presentations to the 14 major trauma centres in NSW remains constant. It is possible that injury prevention measures are having a limited effect on severe injury in NSW. This research provides stimulus for change in the provision and co-ordination in the delivery of trauma care for injured children.
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Randomized Controlled Trial Multicenter Study
Increasing compliance with protective eyewear to reduce ocular injuries in stone-quarry workers in Tamil Nadu, India: a pragmatic, cluster randomised trial of a single education session versus an enhanced education package delivered over six months.
To evaluate the efficacy of standard education versus enhanced education in increasing compliance with protective eyewear to prevent ocular injuries in stone-quarry workers. ⋯ Provision of appropriate protective eyewear reduces the incidence of eye injuries in stone-quarry workers. Periodic educational and motivational sessions with individuals and groups facilitates sustained use of protective eyewear.
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The management of open fractures and delayed or non unions continue to be complicated by high rates of treatment failure and significant patient disability and dissatisfaction. The use of bone morphogenetic proteins (BMPs) in the treatment of these injuries has been assessed by several authors. ⋯ Despite this limited target, off-label BMP use continues to push the spectrum for new applications. This review describes the current evidence for the use of BMPs in open fractures and non-unions.
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Review
Application of scaffolds for bone regeneration strategies: current trends and future directions.
Scaffolds are extensively used in surgery to replace missing bone and to achieve bony union and fusion. An ideal scaffold should not only maintain, induce, and restore biological functions where cells, extracellular matrix, and growth factors are needed, but also have the right properties with respect to degradation, cell binding, cellular uptake, non-immunogenicity, mechanical strength, and flexibility. Here we examine both the basic science behind the development of scaffolds and comprehensively and systematically review the clinical applications.