The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Mar 2012
ReviewEffects on mortality, treatment, and time management as a result of routine use of total body computed tomography in blunt high-energy trauma patients.
Currently, total body computed tomography (TBCT) is rapidly implemented in the evaluation of trauma patients. With this review, we aim to evaluate the clinical implications-mortality, change in treatment, and time management-of the routine use of TBCT in adult blunt high-energy trauma patients compared with a conservative approach with the use of conventional radiography, ultrasound, and selective computed tomography. ⋯ Current literature has predominantly suboptimal design to prove terminally that the routine use of TBCT results in improved survival of blunt high-energy trauma patients. TBCT can give a change of treatment and improves time intervals in the emergency department as compared with its selective use.
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J Trauma Acute Care Surg · Mar 2012
Multicenter Study Comparative StudyHomicide as a medical outcome: racial disparity in deaths from assault in US Level I and II trauma centers.
Since 1900, thousands of medical journal articles have been published on the topic of racial disparities in health and medical outcomes in the United States, including overlapping disparities based on health insurance status. But research on the question of such disparities in the medical treatment of injury from assault-matters of public safety, considerable public expense, and policy debate-is lacking. ⋯ I, prognostic study.
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J Trauma Acute Care Surg · Mar 2012
Comparative StudyManagement of contaminated open fractures: a comparison of two types of irrigation in a porcine model.
Treatment of open fractures demands rapid intervention consisting of intravenous antibiotics, aggressive debridement, fracture immobilization, and soft tissue management including additional debridements and soft tissue coverage. Despite this approach, infection, particularly osteomyelitis, after open fracture continues to be a source of significant morbidity. Recent literature has provided several studies that performed clinical trials in superficial wounds. These investigations compared sterile solutions with tap water for wound decontamination. The results suggest that tap water washouts are cost-effective for these specific wounds. ⋯ There was no significant difference between the CFUs for the sterile and potable water (p = 0.201) for each bacterium (p = 0.871).
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J Trauma Acute Care Surg · Mar 2012
Comparative StudyThe use of temporary abdominal closure in low-risk trauma patients: helpful or harmful?
Temporary abdominal closure (TAC) has become a widely used technique in severely injured patients. However, there is growing concern that TAC is being overutilized. We sought to identify less severely injured patients who underwent TAC and to compare their outcomes with patients managed with a single-stage laparotomy (SSL). ⋯ : III, therapeutic study.
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J Trauma Acute Care Surg · Mar 2012
Comparative StudyA questionable association of stroke volume and arterial pulse pressure under gravitational stress.
The purpose of this study was to examine individual stroke volume-pulse pressure (PP) relationships in healthy young men and women. ⋯ This work highlights the limitations of using PP when assessing trauma patients because of large interindividual differences.