Injury
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Randomized Controlled Trial Comparative Study
Wound closure of leg fasciotomy: Comparison of vacuum-assisted closure versus shoelace technique. A randomised study.
Fasciotomies, though essential for the prevention and management of compartment syndromes, may increase morbidity and prolong hospitalisation. Two widely applied methods of delayed primary closure are compared in leg fasciotomy wounds. ⋯ Both VAC® and the shoelace technique are safe, reliable and effective methods for closure of leg fasciotomy wounds. VAC® requires longer time to definite wound closure and is far more expensive than the shoelace technique, especially when additional skin grafting is required.
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Comparative Study
Outcome of penetrating intracranial injuries in a military setting.
Penetrating intracranial injuries are common in the deployed military medical environment. Early assessment of prognosis includes initial conscious level. There has been no previous identification of different outcomes depending on mechanism of penetrating injury. The aim of this study was to define outcome from penetrating head injury in our population, and to compare outcome between gunshot wound (GSW) and blast fragment injury, in order to detect a difference in survival. ⋯ Most patients who present following penetrating intracranial injury, who have a GCS>5, survive to discharge. There is a significant difference in survival to hospital discharge following penetrating injury caused by blast fragment compared to those caused by GSW, partly attributable to a difference in injury severity. This is the first study to specifically highlight and define this difference.
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Duodenal injury in most cases, presents as a complex trauma of all adjacent organs which it is generally treated with a midline laparotomy though laparoscopic treatment in selected cases might be beneficial. We present a case of haemodynamically stable patient who suffered abdominal gunshot injury causing grade II trauma of the liver and penetrating wound of the first part of the duodenum and was treated laparoscopically. We believe that laparoscopic primary or assisted repair of injured duodenum is an appropriate surgical option in haemodynamically stable patients who sustain focal abdominal trauma.
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Recent military operations in Afghanistan have resulted in considerable lower limb trauma. Associated with this trauma have been serious injuries to the genitalia. No previous study has looked at the effect of traumatic genital injury on the individual. This study expresses the impact of these injuries. ⋯ Better outcomes are achieved for the patient when psychological and surgical support if provided throughout the long treatment and recovery process It is important that every effort is made to preserve fertility right from the point of injury.