J Trauma
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Maintaining good hospital records during military conflicts can provide medical personnel and researchers with feedback to rapidly adjust treatment strategies and improve outcomes. But to convert the resulting raw data into meaningful conclusions requires clear terminology and well thought out equations, utilizing consistent numerators and denominators. Our objective was to arrive at terminology and equations that would produce the best insight into the effectiveness of care at different stages of treatment, either pre or post medical treatment facility care. ⋯ These equations were then applied consistently across data from the WWII, Vietnam and the current Global War on Terrorism. Using this clear set of definitions we used the equations to ask two basic questions: What is the overall lethality of the battlefield? How effective is combat casualty care? To answer these questions with current data, the three services have collaboratively created a joint theater trauma registry (JTTR), cataloging all the serious injuries, procedures, and outcomes for the current war. These definitions and equations, consistently applied to the JTTR, will allow meaningful comparisons and help direct future research and appropriate application of personnel.
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To survey surgeon opinion regarding the management of the open abdomen (OA) and abdominal compartment syndrome (ACS) to assess current practice and direct future prospective clinical studies. ⋯ There is no consensus regarding definition, functional indications, or management of an open abdomen in the perceptions of Canadian trauma providers despite a high self reported level of familiarity with the abdominal compartment syndrome. This is an area of practice with potential and requirements for further multi-center study.
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Comparative Study
Damage control management of experimental grade 5 renal injuries: further evaluation of FloSeal gelatin matrix.
We developed a porcine grade 5 renal laceration damage control model to evaluate the hemostatic efficacy of FloSeal gelatin matrix (Baxter Healthcare, Corp., Deerfield, Ill). ⋯ FloSeal gelatin matrix performed well as a rapidly deployable, effective hemostatic agent in a hypothermic grade 5 renal injury damage control model. The absence of delayed bleeding and nephrotoxicity suggests a possible increased role for FloSeal in the treatment of devastating renal injuries in damage control surgery.
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Biography Historical Article
Reflections of an accidental traumatologist: the Trauma Association of Canada at twenty-one.