European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Apr 2016
Factors affecting morbidity and mortality in pancreatic injuries.
Difficulties in the detection of pancreatic damage result in morbidity and mortality in cases of pancreatic trauma. This study was performed to determine factors affecting morbidity and mortality in pancreatic trauma. ⋯ Complications were significantly more common in injuries with higher pancreatic damage scores, additional organ injuries, and blunt abdominal trauma. Pancreatic injury score was associated with morbidity, while the presence of major vascular injury was associated with mortality.
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Eur J Trauma Emerg Surg · Apr 2016
Segway(®) related injuries in Vienna: report from the Lorenz Böhler Trauma Centre.
The Segway® vehicle facilitates a new way of eco-friendly mobility and is currently used all over the world. In the last years, the use of the Segway® transporters for sightseeing tours in Vienna has increased distinctly, resulting in a growing number of Segway® related injuries and subsequent admissions of these patients to the Lorenz Böhler Trauma Centre in Vienna, Austria. ⋯ This case series presents severe injuries related to the use of a Segway® transporter. As a consequence, it has to be ensured that public tour operators need to provide sufficient safety instructions and equipment for people who are unfamiliar with riding a Segway® .
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Eur J Trauma Emerg Surg · Apr 2016
Tailored ultrasound learning for acute care surgeons: a review of the MUSEC (Modular UltraSound ESTES Course) project.
The European Society for Trauma and Emergency Surgery (ESTES) identified the need for general and trauma surgeons involved in the management of critically ill surgical patients to embrace and learn both basic and advanced US skills. A steering group was created to address this deficit. ⋯ MUSEC is an effective and original educational format, enjoyed by candidates, that fills an educational gap for tailored US education as a procedural skill to acute care surgeons. Ongoing revisions should reduce the current limitations and increase the educational value, in terms of number of modules and post-course credentialing.
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Eur J Trauma Emerg Surg · Apr 2016
Review Practice GuidelineESTES guidelines: acute mesenteric ischaemia.
Acute mesenteric ischaemia (AMI) accounts for about 1:1000 acute hospital admissions. Untreated, AMI will cause mesenteric infarction, intestinal necrosis, an overwhelming inflammatory response and death. Early intervention can halt and reverse this process leading to a full recovery, but the diagnosis of AMI is difficult and failure to recognize AMI before intestinal necrosis has developed is responsible for the high mortality of the disease. Early diagnosis and prompt treatment are the goals of modern therapy, but there are no randomized controlled trials to guide treatment and the published literature contains a high ratio of reviews to original data. Much of that data comes from case reports and often small, retrospective series with no clearly defined treatment criteria. ⋯ The aim of these guidelines is to provide recommendations for practice that will lead to improved outcomes for patients.
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Eur J Trauma Emerg Surg · Apr 2016
ReviewGrade IV renal trauma management. A revision of the AAST renal injury grading scale is mandatory.
The AAST renal injury grading scale is currently the most important variable predicting the need for kidney repair or removal, morbidity and mortality after blunt or penetrating kidney injuries. The 2011 revised version included renal pelvis, uretero-pelvic junction and segmental vascular injuries as grade IV, limiting grade V to severe hilar injuries. However, patients requiring surgery cannot be properly identified because of hemodynamic instability due to grade IV renal injuries. This study proposes an add-on for the AAST grade IV renal injury scale to improve the management of these patients. ⋯ These elements should be included in future classification reassessment to efficiently determine the time for surgery in grade IV renal traumas, generally leading to nephrectomy.