European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Jan 2025
Comparative StudyDoes a gentamicin-coated intramedullary nail prevent postoperative infection in Gustilo type I and II tibial open fractures? A comparative study and retrospective analysis.
Tibial open shaft fractures are very common and susceptible to infection, which can lead to significant morbidity especially infection and non-union. Antibiotic coated nail is one option for fixing open shaft tibial fractures to minimise infection. This study aimed to compare the clinical outcome of Gentamicin-coated tibial nails versus regular unreamed interlocking tibial nails in the treatment of type I and II tibial open fractures. ⋯ We hypothesized that Gentamicin-coated nail is effective in preventing infection in Gustilo type I and II open fractures compared to non-antibiotic-coated regular nails.
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Eur J Trauma Emerg Surg · Jan 2025
Observational StudyExtracorporeal membrane oxygenation in trauma: a single-center retrospective observational study.
Globally, trauma is a leading cause of death in young adults. The use of extracorporeal membrane oxygenation (ECMO) in the trauma population remains controversial due to the limited published research. This study aimed to analyze 30-day survival of all the trauma ECMO patients at our center, with respect to injury severity score (ISS) and new injury severity score (NISS). ⋯ This study indicates that trauma patients may benefit from ECMO, independent of severity. Furthermore, our results support ECMO transport as feasible in trauma patients. We recommend larger multi-center studies to determine which trauma patients would have the greatest benefit of ECMO.
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Eur J Trauma Emerg Surg · Jan 2025
Assessing the role of chest CT in minor blunt trauma: evaluation of the NEXUS decision instrument across an expanded population.
To evaluate the NEXUS Chest CT ALL decision instrument (DI) in reducing unnecessary chest CT imaging in minor blunt trauma patients while preserving high sensitivity for detecting clinically meaningful injuries. Additionally, we examined the impact of delayed presentation, chronic disease, and anticoagulation/anti-aggregation medications on trauma outcomes. ⋯ The NEXUS Chest CT ALL DI significantly reduces unnecessary imaging while maintaining high diagnostic precision. A modified version enhances sensitivity, refining decision-making in emergency care. Integrating such decision tools, particularly in cases of minor trauma, is highly recommended to optimize resource use and improve patient outcomes.
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Eur J Trauma Emerg Surg · Jan 2025
Quality of referrals and adherence to guidelines for adult patients with minimal to moderate head injuries in a selection of Norwegian hospitals.
This study aimed to assess adherence to the Scandinavian guidelines, the justification of referrals, and the quality of referrals of patients with mild, minimal, and moderate head injuries in a selection of Norwegian hospitals. ⋯ Adherence to the Scandinavian guidelines and the quality of referrals of patients with mild, minimal, and moderate head injuries are low. Training and using S100B is recommended to improve the justification rate and quality of patient care.
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Eur J Trauma Emerg Surg · Jan 2025
Ulnoradial - metacarpal reconstruction for emergency one-stage procedure in complicated wrist amputation.
Complicated wrist amputation caused by severe trauma poses a real challenge for orthopedic and hand surgeons. This study aimed to evaluate a procedure of ulnoradial-metacarpal reconstruction as a rescue option in this challenging situation. ⋯ Therapeutic IV.