European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Oct 2023
Revisiting abdominal closure in mesenteric ischemia: is there an association with outcome?
Current guidelines advocate liberal use of delayed abdominal closure in patients with acute mesenteric ischemia (AMI) undergoing laparotomy. Few studies have systematically examined this practice. The goal of this study was to evaluate the effect of delayed abdominal closure on postoperative morbidity and mortality in patients with AMI. ⋯ The delayed fascial closure technique was associated with increased mortality compared to immediate fascial closure. These findings do not support the blanket incorporation of delayed closure in mesenteric ischemia care or its previously advocated liberal use.
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Eur J Trauma Emerg Surg · Oct 2023
The Blunt Liver and Spleen Trauma (BLAST) audit: national survey and prospective audit of children with blunt liver and spleen trauma in major trauma centres.
To compare the reported and observed management of UK children with blunt liver or spleen injury (BLSI) to the American Pediatric Surgical Association (APSA) 2019 BLSI guidance. ⋯ UK management of BLSI differs from many aspects of APSA guidance. A shift towards using clinical features to determine ICU admission and readiness for discharge is demonstrated, in line with a strong evidence base. However, routine bed rest and re-imaging after BLSI is common, contrary to APSA guidance. This disparity may exist due to concern that evidence around the incidence, presentation and natural history of complications after conservatively managed BLSI, particularly bleeding from pseudoaneurysms, is weak.
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Eur J Trauma Emerg Surg · Oct 2023
Outcome of laparotomy and conservative treatment of patients with acute mesenteric venous ischemia with viable bowel.
Acute mesenteric ischemia (AMI) is one of the most serious abdominal emergencies. Predicting the onset of bowel necrosis that warrants surgical intervention is of paramount importance in AMI. The present study aimed to investigate the outcome of patients with AMI secondary to mesenteric venous occlusion (MVO) and the consequence of non-therapeutic exploratory laparotomy. ⋯ Careful assessment and informed decision-making in patients with AMVI are crucial to avoid unnecessary surgical intervention that can result in higher rates of complications and readmission and extended hospital stay.
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Eur J Trauma Emerg Surg · Oct 2023
Comparing outcomes of total hip arthroplasty versus hemiarthroplasty in neck of femur fracture patients: an Australian registry study.
To determine discharge outcomes of displaced subcapital NOF patients who were from home, with intact pre-operative cognition, ASA 1 or 2 and independent walkers treated with either THA or hemiarthroplasty. ⋯ Displaced subcapital NOF patients who were admitted from home, had intact pre-operative cognition, ASA 1 or 2, independent walkers and had THAs, had shorter total hospital length of stay, were more likely to be discharged home directly and less likely to end up in residential aged care facilities compared to those undergoing hemiarthroplasty.
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Eur J Trauma Emerg Surg · Oct 2023
Is acute appendicitis more severe in foreign workers of northern Israel? A retrospective cohort study.
Acute appendicitis (AA) is one of the most common surgical emergencies worldwide. It's classified into simple or complicated disease. Due to the high prevalence of the disease, AA has been studied as a marker to assess the quality of care afforded to minority groups. The purpose of this study was to compare AA outcomes in foreign workers (FW) to the general population in northern Israel. ⋯ Although duration of symptoms was comparable to the local population, FW in northern Israel are at increased risk for a complicated disease which resulted in longer hospital stay. Further studies may enlighten the reason for this disparity.