European journal of trauma and emergency surgery : official publication of the European Trauma Society
-
Eur J Trauma Emerg Surg · Jun 2024
Moving toward point-of-care surgery in Ukraine: testing an ultra-portable operating room in an active war zone.
In conflict zones, providers may have to decide between delaying time-sensitive surgeries or performing operative interventions in the field, potentially subjecting patients to significant infection risks. We conducted a single-arm crossover study to assess the feasibility of using an ultraportable operating room (U-OR) for surgical procedures on a porcine cadaver abdominal traumatic injury model in an active war zone. ⋯ The use of the U-OR did not affect the procedure completion rate or SURG-TLX. However, there was a marked difference in airborne particle counts between inside and outside the U-OR during surgery. These preliminary findings indicate the potential feasibility of using a U-OR to perform abdominal damage-control surgical procedures in austere settings.
-
Eur J Trauma Emerg Surg · Jun 2024
The 'Shish-Kebab technique' in intra-articular fractures of the hamate body and concomitant 4th metacarpal base fracture.
Hamate fractures are infrequent and often overlooked wrist injuries. Our objective is to present the Shish-Kebab method, a surgical approach utilized in the treatment of intra-articular Hamate body fractures occurring concurrently with fourth metacarpal base fractures and dislocations. ⋯ In the management of Hamate body intra-articular fractures and accompanying fourth metacarpal base fracture dislocations, good clinical results can be achieved with the 'Shish-Kebab' method in cases where closed reduction is unsuccessful.
-
Polytrauma is increasingly recognized as a disease beyond anatomical injuries. Due to population growth, centralization, and slow uptake of preventive measures, major trauma presentations in most trauma systems show a slow but steady increase. The proportional contribution of polytrauma patients to this increase is unknown. ⋯ Polytrauma patients represent about 25% of the major trauma admissions, with higher injury severity, static incidence and higher but improving mortality in comparison to all major trauma patients. Separate reporting and focused research on this group are warranted as monitoring the entire major trauma cohort does not identify these specifics of this high acuity subgroup.
-
Eur J Trauma Emerg Surg · Jun 2024
Lessons learned during the sliding gantry CT implementation in a trauma suite.
Early detection of bleeding is important for managing trauma cases in the emergency department (ED). Several trauma suites are equipped with computed tomography (CT) scanners to reduce the time to CT. In the last decade, sliding gantry CT has been implemented in trauma suites, highlighting conventional techniques' advantages. We investigated the change in the time to CT and the challenges faced during the implementation. ⋯ We have demonstrated a decrease in the time to CT with the implementation of a sliding gantry CT. However, due to a higher number of cable management problems in the routine use group, we recommend regular refresher team training with routine use.
-
Eur J Trauma Emerg Surg · Jun 2024
ReviewMental health is strongly associated with capability after lower extremity injury treated with free flap limb salvage or amputation.
Knowledge about factors associated with long-term outcomes, after severe traumatic injury to the lower extremity, can aid with the difficult decision whether to salvage or amputate the leg and improve outcome. We therefore studied factors independently associated with capability at a minimum of 1 year after amputation or free flap limb salvage. ⋯ This study adds to the growing body of knowledge that physical health is best regarded through the lens of the bio-psycho-social model in which mental health is a strong determinant. This study supports making mental health an important aspect of rehabilitation after major lower extremity injury, regardless of amputation or limb salvage.