J Trauma
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Review Meta Analysis Comparative Study
Does colostomy prevent infection in open blunt pelvic fractures? A systematic review.
Open pelvic fracture is a rare injury. Our aim in this study is to systematically review the literature to define when diverting colostomy is indicated to protect the patient from infection in open blunt pelvic fractures. ⋯ The role of colostomy in open blunt pelvic fractures is unresolved and randomized multicenter trials are needed.
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Major trauma and burns are associated with whole body catabolism which can persist for 1 or more years after injury. This study investigates body composition in massively burned children for up to 2 years. ⋯ Body composition of severely burned children significantly improved in the second year compared with the first year after injury. This demonstrates a need for long-term rehabilitation in these burn patients.
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Comparative Study Clinical Trial
Evaluation of possible tourniquet systems for use in the Canadian Forces.
Hemorrhage from extremity wounds is the leading cause of preventable death on the battlefield. Tourniquets have been identified as the most reasonable option for controlling life threatening extremity hemorrhage in the tactical phase of an operation. The purpose of this trial was to determine which tourniquet systems are effective under simulated combat conditions and make recommendations to the Canadian Forces (CF) on an approach to tourniquet use. ⋯ The most effective tourniquets were the EMT and ST. The ST is also the lightest, fastest, easiest to learn, and the cheapest but it causes a lot of pain and presumably, local tissue damage. ST can be issued to every soldier with a minimum of training and used effectively in the "Care Under Fire" phase. The EMT, which causes the least pain and is equally effective, can be applied during the "Tactical Field Care" phase by the medic to replace the surgical tubing. Fine adjustments can be made to the EMT, which allows the medic to safely deflate the device, assess the wound, determine if a tourniquet is required, and re-inflate quickly if necessary.