The potential of point-of-care diagnostics to optimise prehospital trauma triage: a systematic review of literature
DiscussionA preliminary version of a modified triage algorithm with hypothetic cut-off values for a trauma team activation was created. However, further studies should be conducted to optimize the final cut-off values in the future. Furthermore, studies need to evaluate the practical application of the modified algorithm in terms of feasibility (e.g. duration of application, technique, etc.) and the effects of the new algorithm on over-triage. Limiting factors are the restriction with the search and the heterogeneity between the studies (e.g. varying measurement devices, techniques etc.). (Source: European Journal of Traum...
Source: European Journal of Trauma and Emergency Surgery - January 26, 2023 Category: Emergency Medicine Source Type: research

Techniques for mesoappendix transection and appendix resection: insights from the ESTES SnapAppy study
ConclusionsSafe mesoappendix transection and appendix resection are accomplished using heterogeneous techniques. Technique selection for both mesoappendix transection and appendix resection correlates with AAST grade. Higher grade led to more ultrasonic tissue transection and stapled appendix resection. Higher AAST appendicitis grade also correlated with infection-related complication occurrence. Despite the overall well-tolerated heterogeneity of approaches to acute appendicitis, increasing disease acuity or complexity appears to encourage homogeneity of intraoperative surgical technique toward advanced adjuncts. (Source:...
Source: European Journal of Trauma and Emergency Surgery - January 24, 2023 Category: Emergency Medicine Source Type: research

Syringic acid ameliorates ischemia/reperfusion-induced testicular injury in rats via suppressing of HMGB1/NF- κB axis and endoplasmic reticulum stress
ConclusionThe overall results suggest that syringic acid emerges as a potential compound for the treatment of testicular torsion and may be subject to clinical trials. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - January 24, 2023 Category: Emergency Medicine Source Type: research

Does minimally invasive percutaneous transilial internal fixator became an effective option for sacral fractures? A prospective study with novel implantation technique
ConclusionTIFI through a minimally invasive technique represents a valid method for dealing with transforaminal sacral fractures. TIFI provides a rigid fixation for posterior ring injuries with few risks regarding iatrogenic nerve injury, avoiding different variations of upper sacral osseous anatomy or sacral dysmorphism. In addition, there is no necessity for high quality fluoroscopy for visualization of sacral foramina intraoperatively, decreasing risk of radiation exposure, unlike other methods of fixation as iliosacral screws. Our novel modification for implantation technique provides few risks for postoperative and wo...
Source: European Journal of Trauma and Emergency Surgery - January 24, 2023 Category: Emergency Medicine Source Type: research

The potential impact of coagulation factor XIII in trauma-induced coagulopathy – a retrospective case series analysis
ConclusionsThe substitution of FXIII in patients who were more seriously compromised due to higher lactate levels and who presented with initially more severe bleedings than patients in the control group, resulted in a comparable transfusion necessity after 24  h. Thus, we guess that the substitution of FXIII in severely injured patients with ongoing bleeding might have an impact on their clinical outcome. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - January 21, 2023 Category: Emergency Medicine Source Type: research

Is hospital volume related to quality of hip fracture care? Analysis of 43,538 patients and 68 hospitals from the Dutch Hip Fracture Audit
ConclusionThis is the first study analyzing the effect of hospital volume on hip fracture care, treating volume as a continuous parameter. Mortality and turnaround times showed no clinically relevant association with hospital volume. The provision of orthogeriatric co-treatment, however, increased with increasing volumes up to 367 patients per year, but decreased above this threshold. Future research on the effect of volume on complications and functional outcomes is indicated. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - January 21, 2023 Category: Emergency Medicine Source Type: research

Early total care or damage control orthopaedics for major fractures ? Results of propensity score matching for early definitive versus early temporary fixation based on data from the trauma registry of the German Trauma Society (TraumaRegister DGU ®)
ConclusionWe could identify some parameters of polytrauma patients used in the trauma registry (Traumaregister DGU®), which led more likely to a DCO therapy. The propensity score did not demonstrate the superiority of DCO over ETC in terms of outcome or complications. It did not appear to adequately adjust for the variables used here. Definitive evidence for or against the use of DCO remains unavailable. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - January 20, 2023 Category: Emergency Medicine Source Type: research

Surgical management of acute appendicitis during the European COVID-19 second wave: safe and effective
ConclusionDuring sequential SARS-CoV-2 infection waves, neither active nor prior SARS-CoV-2 infection was associated with prolonged hospital LOS or postoperative complication. Despite early concerns regarding postoperative safety and outcome during active SARS-CoV-2 infection, no such association was noted for those with appendicitis who underwent operative management. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - January 19, 2023 Category: Emergency Medicine Source Type: research

Evaluating temporal trends and the impact of surgical subspecialisation on patient outcomes following adhesional small bowel obstruction: a multicentre cohort study
ConclusionOutcomes for patients presenting with adhesional SBO have improved despite the increasing burden of age and co-morbidity. While gastrointestinal subspecialists are increasingly responsible for their care, mortality is not influenced by consultant subspecialty. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - January 19, 2023 Category: Emergency Medicine Source Type: research

Emergency approach to the femoral artery
ConclusionIn conclusion, we evaluated the emergency access to the femoral artery (FA) and femoral vein (FV) as an easily teachable procedure including high success rates (correct performance in 97.2%). (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - January 19, 2023 Category: Emergency Medicine Source Type: research

Epidemiology of carpal fractures: is it only about the scaphoid?
AbstractBecause of their low incidence, studies about carpal fractures are rare. The aim of the present study was to analyze epidemiology and treatment of fractured carpal bones. We retrospectively analyzed data of 178 patients admitted to our emergency room with carpal fractures over 6  years. More males than woman were injured. In 91%, a CT scan was performed. The most commonly affected bone was the triquetrum followed by the scaphoid. Almost all triquetral fractures were treated conservatively as opposed to perilunate dislocations that were all operated on. Half of all patients with scaphoid fractures were operated. Yo...
Source: European Journal of Trauma and Emergency Surgery - January 17, 2023 Category: Emergency Medicine Source Type: research

A prospective comparative study of the functional results associated with the use of Bj örk flap tracheostomy versus standard tracheostomy
ConclusionWe conclude that BFT may be associated with an overall shorter time to restoration of normal swallowing when compared to ST. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - January 17, 2023 Category: Emergency Medicine Source Type: research

Graded operative autonomy in emergency appendectomy mirrors case-complexity: surgical training insights from the SnapAppy prospective observational study
ConclusionThe linkage of case complexity with operator experience within the context of graduated autonomy is a central tenet of surgical training. Either subconsciously, or by design, patients operated on by trainees were younger, fitter and with earlier stage disease. At least in part, these explain why clinical outcomes following appendectomy do not differ depending on the experience of the operating surgeon. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - January 16, 2023 Category: Emergency Medicine Source Type: research

Reducing the incidence and mortality of traumatic brain injury in Latin America
AbstractTraumatic brain injury (TBI) represents a considerable portion of the global injury burden. The incidence of TBI will continue to increase in view of an increase in population density, an aging population, and the increased use of motor vehicles, motorcycles, and bicycles. The most common causes of TBI are falls and road traffic injuries. Deaths related to road traffic injury are three times higher in low-and middle-income countries (LMIC) than in high-income countries (HIC). The Latin American Caribbean region has the highest incidence of TBI worldwide, primarily caused by road traffic injuries. Data from HIC indi...
Source: European Journal of Trauma and Emergency Surgery - January 13, 2023 Category: Emergency Medicine Source Type: research

Letter to the Editor concerning “Mortality and functional outcomes of fragility fractures of the pelvis by fracture type with conservative treatment: a retrospective, multicenter TRON study”
(Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - January 13, 2023 Category: Emergency Medicine Source Type: research