European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Aug 2019
Multicenter Study Observational StudyImpact of cardiopulmonary resuscitation time on the effectiveness of emergency department thoracotomy after blunt trauma.
Debate remains about the threshold cardiopulmonary resuscitation (CPR) duration associated with futile emergency department thoracotomy (EDT). To validate the CPR duration associated with favorable outcomes, we investigated the relationship between CPR duration and return of spontaneous circulation (ROSC) after EDT in blunt trauma. ⋯ A CPR duration < 17 min is independently associated with higher ROSC rates in patients suffering blunt trauma.
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Eur J Trauma Emerg Surg · Aug 2019
Observational Study"Second-look" laparotomy: warranted, or contributor to excessive open abdomens?
The overuse of temporary abdominal closure and second look (SL) laparotomy in emergency general surgery (EGS) cases has been questioned in the recent literature. In an effort to hopefully decrease the number of open abdomen (OA) patients, we hypothesize that reviewing our cases, many of these SL patients could be managed with single-stage operative therapy and thus decrease the number of OA patients. ⋯ Almost one-fifth of the patients undergoing SL laparotomy for open abdomen required bowel resections, with 6.8% of those having normal appearing bowel at index operation, therefore in select EGS patients, SL laparotomy is a reasonable strategy.
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Eur J Trauma Emerg Surg · Aug 2019
Rib osteosynthesis is a safe and effective treatment and leads to a significant reduction of trauma associated pain.
The usefulness of chest wall stabilization after blunt chest wall trauma with unstable rib fractures has recently been intensely discussed. Thereby, the surgical approach seems to influence outcome, mortality and the long-term complication rate including chronic chest pain, thoracic deformity and quality of life. Here, we present the outcome after surgical stabilization of unstable rib fractures using intramedullary splints and plate osteosynthesis. ⋯ Rib osteosynthesis is a safe and effective treatment option for patients with unstable rib fractures after blunt chest wall trauma. It leads to a significant reduction of the trauma-associated pain caused by the rib fractures and supports a quick recovery of the patients.
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Eur J Trauma Emerg Surg · Aug 2019
Medial humeral condyle fracture in childhood: a rare but often overlooked injury.
The medial condyle fracture of the humerus is-in comparison to the lateral condyle fracture-a very rare Salter-Harrison IV-fracture of the elbow. In this prospective study 14 children were included and reviewed. One child had minimal displacement fracture type I, one child had type II, and 12 children had type III-fractures. ⋯ If in this injury the diagnosis is made without delay, an appropriate therapy is implemented and radiographical controls are performed until consolidation, good results can be expected. The main risk in medial condyle fractures of the humerus is to overlook them. This can lead to the development of a nonunion with joint malformations.
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Eur J Trauma Emerg Surg · Aug 2019
Clinical consequences of chest tube malposition in trauma resuscitation: single-center experience.
Evaluation of trauma patients with chest tube malposition using initial emergency computed tomography (CT) and assessment of outcomes and the need for chest tube replacement. ⋯ Patients with malposition of emergency chest tubes according to CT were not associated with worse outcomes compared to patients with correctly positioned tubes. Early emergency chest CT in the initial evaluation of severely injured patients allows precise detection of possible malposition of chest tubes that may require immediate intervention.