European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Microsurgery courses, taught external to surgical training programs, are essential for acquiring the high level of technical skill required for clinical proficiency. ⋯ The microcourse significantly increased trainees' clinical microsurgery skills, confidence, and the number of clinical cases they perform. Of all the anastomosis techniques taught, venous anastomosis and grafting were the most difficult to learn. The presence of a full-time experienced instructor was most important.
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Eur J Trauma Emerg Surg · Jun 2017
Observational StudyAssessing the impact of fracture pattern on transfusion requirements in hip fractures.
Hip fractures in the elderly represent a major source of morbidity and mortality, with allogeneic blood transfusions (ABTs) associated with increased mortality. This study assesses the ABT requirements between the most common patterns of hip fracture; intertrochanteric (IT) and intracapsular (IC). The impact of operation type on transfusion rates was also assessed. ⋯ Patients with IT hip fractures are significantly more likely to require an ABT than those with IC hip fractures. Patients undergoing an intramedullary nail for IT fractures have significantly higher transfusion rates than for other types of operation.
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Hydatid cyst rupture into abdominal cavity is a rare but a serious complication. The rupture can occur after a trauma, or spontaneously as a result of increased intracystic pressure. It is a surgical emergency with high morbidity and mortality rates. Early diagnosis and appropriate surgical management of this complication can be life saving. The objective of the current paper is to evaluate the clinical, and radiographic findings and surgical treatment of this complication. ⋯ Hydatid cyst rupture in peritoneal cavity is a rare complication. Imaging assessment has an important role in diagnosis but clinical signs are mandatory. A quick diagnosis and emergency surgery can decrease postoperative death. Surgery and postoperative care constitute the basis of treatment.
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Eur J Trauma Emerg Surg · Jun 2017
The survival impact of plasma to red blood cell ratio in massively transfused non-trauma patients.
High ratios of Plasma to Packed Red Blood Cells (FFP:PRBC) improve survival in massively transfused trauma patients. We hypothesized that non-trauma patients also benefit from this transfusion strategy. ⋯ In non-trauma patients undergoing massive transfusion, increasing FFP:PRBC ratio was associated with improved survival. A ratio >1:3 significantly improved survival probability.
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Eur J Trauma Emerg Surg · Jun 2017
Expertise of German paramedics concerning the prehospital treatment of patients with spinal trauma.
Spinal immobilization is a standard procedure in emergency medicine. Increasing awareness of complications associated with immobilization of trauma patients leads to controversial discussions in the literature. Current guidelines require to include considerations of accident mechanism, an assessment of the patient's condition and an examination of the spine in the decision-making process if immobilization of the spine should be performed. This requires sound knowledge of assessing these parameters. The aim of the current study is to analyze German paramedics' subjective uncertainty in terms of their prehospital assessment and treatment of patients suffering from spine injuries. ⋯ Paramedics do not feel uncertain about the prehospital assessment and treatment of spinal injuries. The feeling of confidence in participants who had already attended a course on the treatment of trauma patients before was significantly higher.