Annals of surgery
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To report the distribution and types of injuries in victims of suicide bombing attacks and to identify external signs that would guide triage and initial management. ⋯ Easily recognizable external signs of trauma can be used to predict the occurrence of BLI and intra-abdominal injury. The importance of these signs needs to be incorporated into triage protocols and used to direct victims to the appropriate level of care both from the scene and in the hospital.
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To construct risk indices predicting adverse outcomes following surgery for small bowel obstruction (SBO). ⋯ Morbidity and mortality after surgery for SBO in VA hospitals are comparable with those in other large series. The morbidity rate, but not the mortality rate, is significantly higher in patients requiring small bowel resection compared with those requiring adhesiolysis only (P < 0.001). The risk indices presented provide an easy-to-use tool for clinicians to predict outcomes for patients undergoing surgery for SBO.
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Since 1993, there has been an increase in the number of postgraduate fellowships in minimally invasive and gastrointestinal (GI) surgery; from 9 in 1993 to more than 80 in 2004. Early on, there was no supervision or accreditation of these fellowships, and they varied widely in content, structure, and quality. This was widely recognized as being a bad situation for fellow applicants and reflected poorly on the specialties of minimally invasive (MI) and GI surgery. In an effort to bring order to this chaotic situation, the Minimally Invasive Surgery Fellowship Council (MISFC) was founded in 1997. ⋯ The MISFC has been successful at realizing its goals of bringing order to the past chaos of the MIS and GI fellowship situation. Its current iteration, the Fellowship Council, is in the process of introducing an accreditation process to further ensure the highest quality of postgraduate training in the fields of GI and endoscopic surgery.
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To suggest guidelines for hospital organization during terror-related multiple casualty incidents (MCIs) based on the experience of 6 level I trauma centers. ⋯ High staffing demands for ED, OR, and ICU overlap. Anesthesiologists, general, thoracic, and vascular surgeons are in immediate demand. ICU admissions occur simultaneously with ongoing patient arrival to the ED. Most patients operated within the first 2 hours require multidisciplinary surgical teams. Demand for orthopedic and plastic surgery and anesthesiology services continues for >24 hours.