European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Dec 2020
Observational StudyUsefulness of Gram stain examination of peritoneal fluid in postoperative peritonitis to guide empirical antibiotherapy.
In postoperative peritonitis, Gram stain examination (GSE) of peritoneal fluid has been proposed as a guide for the prescription of glycopeptides and antifungal therapy in empirical antibiotherapy. No data support this approach for Gram-positive cocci. We aimed to evaluate the performance of GSE in predicting the results of the culture of peritoneal fluid. ⋯ GSE shows poor performance to predict the results of culture of peritoneal fluid in postoperative peritonitis. Avoiding covering resistant GPC cannot be based on the result of GSE.
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Eur J Trauma Emerg Surg · Dec 2020
Outcome after surgical treatment of complex elbow fractures: a single-center follow-up study.
Elbow injuries present particular challenges for the treating surgeons. The aim of the present study was to evaluate the postoperative outcome after surgical treatment of complex elbow fractures. ⋯ The surgical treatment of complex elbow fractures was associated with good to excellent clinical results. However, distal intra-articular humerus fractures presented the most prominent loss of elbow motion in the follow-up examination.
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Shotgun wounds pose diagnostic challenges due to variable fragment penetration and degradation of CT images. This study compared epidemiology and outcomes between shotgun wounds and gunshot wounds (GSWs), and defined the diagnostic capabilities of CT scan after shotgun wounds. ⋯ Shotgun injuries are far less frequent than GSWs but generally follow the same diagnostic and therapeutic considerations. Clinicians must be aware of the pitfalls of CT scanning after shotgun injuries, which can be falsely positive or falsely negative. A high index of suspicion for injury and a period of observation after negative CT scan may, therefore, be prudent.
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Eur J Trauma Emerg Surg · Dec 2020
Mobile wireless monitoring system for prehospital emergency care.
Latest achievement technologies allow engineers to develop medical systems that medical doctors in the health care system could not imagine years ago. The development of signal theory, intelligent systems, biophysics and extensive collaboration between science and technology researchers and medical professionals, open up the potential for preventive, real-time monitoring of patients. With the recent developments of new methods in medicine, it is also possible to predict the trends of the disease development as well the systemic support in diagnose setting. Within the framework of the needs to track the patient health parameters in the hospital environment or in the case of road accidents, the researchers had to integrate the knowledge and experiences of medical specialists in emergency medicine who have participated in the development of a mobile wireless monitoring system designed for real-time monitoring of victim vital parameters. Emergency medicine responders are first point of care for trauma victim providing prehospital care, including triage and treatment at the scene of incident and transport from the scene to the hospital. Continuous monitoring of life functions allows immediate detection of a deterioration in health status and helps out in carrying out principle of continuous e-triage. In this study, a mobile wireless monitoring system for measuring and recording the vital parameters of the patient was presented and evaluated. Based on the measured values, the system is able to make triage and assign treatment priority for the patient. The system also provides the opportunity to take a picture of the injury, mark the injured body parts, calculate Glasgow Coma Score, or insert/record the medication given to the patient. Evaluation of the system was made using the Technology Acceptance Model (TAM). In particular we measured: perceived usefulness, perceived ease of use, attitude, intention to use, patient status and environmental status. ⋯ The study results show that the proposed system is well accepted by the EM personnel and can be used as a complementary system in EM department for continuous monitoring of patients' vital signs.
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Eur J Trauma Emerg Surg · Dec 2020
Comparative StudyBiomechanical aspects of the posteromedial split in bicondylar tibial plateau fractures-a finite-element investigation.
To gain principal insight into fixation techniques of a posteromedial split fragment in bicondylar tibial plateau fractures. ⋯ The results indicate that the additional fixation of a posteromedial split fracture by plate osteosynthesis might be advantageous in bicondylar tibial plateau fractures treated with lateral plating. This might be even more important in patients with low bone quality.