J Trauma
-
Randomized Controlled Trial Multicenter Study Clinical Trial
Recombinant factor VIIa as adjunctive therapy for bleeding control in severely injured trauma patients: two parallel randomized, placebo-controlled, double-blind clinical trials.
Uncontrolled bleeding is a leading cause of death in trauma. Two randomized, placebo-controlled, double-blind trials (one in blunt trauma and one in penetrating trauma) were conducted simultaneously to evaluate the efficacy and safety of recombinant factor VIIa (rFVIIa) as adjunctive therapy for control of bleeding in patients with severe blunt or penetrating trauma. ⋯ Recombinant FVIIa resulted in a significant reduction in RBC transfusion in severe blunt trauma. Similar trends were observed in penetrating trauma. The safety of rFVIIa was established in these trauma populations within the investigated dose range.
-
Multicenter Study Comparative Study
Trauma base knowledge and the effect of the trauma evaluation and management program among senior medical students in seven countries.
We compared base trauma knowledge and the impact of the Trauma Evaluation and Management (TEAM) program among senior medical students in seven countries. ⋯ Base trauma knowledge in these students, though variable, was generally very low and improved with TEAM. Our data suggest a need for greater undergraduate emphasis in trauma education.
-
Trauma patients with surgical procedures, acute lung injury (ALI), systemic inflammatory response syndrome (SIRS), and longer exposure to invasive devices may be at increased risk for hospital-associated infection (HAI). HAIs have been shown to affect outcome measures, but the extent is not well studied. ⋯ In this study of trauma patients, ISS had the greatest effect on LOS, but increased age and presence of HAI did increase LOS and cost of care. HAI increased LOS more in the less severely injured patients.
-
The technique of percutaneous screw fixation, with increasing popularity, has been successfully conducted in non-displaced, stable scaphoid fractures resulting in shortened immobilization duration and prompt functional retrieval. The purpose of this study was to evaluate the surgical technique and to explore the potential benefits of using percutaneous screw fixation in unstable scaphoid fractures. ⋯ The technique of percutaneous screw fixation was successfully used to treat 11 unstable scaphoid fractures. The encouraging outcome of this treatment option and the prompt functional recovery deserve further investigation. Further randomized prospective studies to explore the specific indications and ubiquitous benefits of the technique presented herein are recommended.