Ulus Travma Acil Cer
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Ulus Travma Acil Cer · Jan 2009
Comparison of POSSUM and P-POSSUM for risk-adjusted audit of patients undergoing emergency laparotomy.
The Physiological and Operative Severity Score for Enumeration of Mortality and Morbidity (POSSUM) scoring system, derived from a heterogeneous population, has been used successfully as an audit tool, but it has appeared to over-predict mortality in low-risk groups for which an alternative system, the Portsmouth predictor equation for mortality (P-POSSUM) was designed and used successfully. In this prospective study, we compared these two equations in predicting death and tested their validity in predicting morbidity and mortality in patients undergoing emergency laparotomy in a tertiary hospital. ⋯ P-POSSUM is a better equation than POSSUM in predicting mortality, and exponential method is better than linear regression analysis. Both equations are useful tools for risk-adjusted surgical audit of patients undergoing emergency laparotomy.
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Ulus Travma Acil Cer · Jan 2009
Is the zeolite hemostatic agent beneficial in reducing blood loss during arterial injury?
Uncontrolled hemorrhage is the leading cause of fatality. The aim of this study was to evaluate the effect of zeolite mineral (QuikClot - Advanced Clotting Sponge [QC-ACS]) on blood loss and physiological variables in a swine extremity arterial injury model. ⋯ According to the physiological parameters, we observed that zeolite tends to reduce blood loss, however could not stop bleeding completely. We believe that further clinical trials are needed to conclude that zeolite could be used in the routine practice.
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Ulus Travma Acil Cer · Jan 2009
Accuracy of sonography in detection of renal injuries caused by blunt abdominal trauma: a prospective study.
This prospective study was conducted to evaluate the accuracy of sonography in detection of renal injuries caused by blunt abdominal trauma. ⋯ In spite of the availability and ease of performance of sonography in evaluation of trauma victims, this imaging modality has low sensitivity in detection of renal injuries and overlooks significant damages. CT scan should be considered as the diagnostic modality in victims of kidney trauma who are hemodynamically stable and have clear indications for renal imaging.
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Penetrating spinal cord injuries caused by stab wounds are rare. Such injuries may result from a direct lesion of the neural elements of the spinal cord, cord infarcts or, more rarely, intradural or epidural hematoma. In the present study, two cases with spinal cord and L4 root injuries caused by a knife are presented. ⋯ The second patient referred to our emergency outpatient clinic with a torso injury caused by a sharp knife. The knife was embedded 2-3 cm deep at the wound site at the L3 level and the handle was broken. The patient was immediately operated and the broken and embedded metallic part of the knife was extracted.
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Ulus Travma Acil Cer · Jan 2009
Preputial skin can be used in all boys with burns requiring grafting.
In patients with extensive burns, all unburned areas can be used as donor sites. In male patients with small burns, preputial skin graft may be a good choice in order to avoid donor site problems. ⋯ Preputial skin is a full-thickness, highly elastic and easy-to-harvest graft that should be considered in all burned male children in whom grafting is needed.