The Surgical Clinics of North America This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Trauma Demographics and Injury Prevention
Surg Clin North Am. 2024 Apr;104(2):243-254. doi: 10.1016/j.suc.2023.11.013. Epub 2024 Jan 25.ABSTRACTTraumatic injury is a leading cause of death in the United States. Risk of traumatic injury varies by sex, age, geography, and race/ethnicity. Understanding the nuances of risk for a particular population is essential in designing, implementing, and evaluating injury prevention initiatives.PMID:38453299 | DOI:10.1016/j.suc.2023.11.013 (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - March 7, 2024 Category: Surgery Authors: Marinda Scrushy Nicole Lunardi Joseph V Sakran Source Type: research

Societal Burden of Trauma and Disparities in Trauma Care
Surg Clin North Am. 2024 Apr;104(2):255-266. doi: 10.1016/j.suc.2023.09.009. Epub 2023 Oct 28.ABSTRACTTrauma imposes a significant societal burden, with injury being a leading cause of mortality worldwide. While numerical data reveal that trauma accounts for millions of deaths annually, its true impact goes beyond these figures. The toll extends to non-fatal injuries, resulting in long-term physical and mental health consequences. Moreover, injury-related health care costs and lost productivity place substantial strain on a nation's economy. Disparities in trauma care further exacerbate this burden, affecting access to tim...
Source: The Surgical Clinics of North America - March 7, 2024 Category: Surgery Authors: Sabrina D Goddard Molly P Jarman Zain G Hashmi Source Type: research

Prehospital Trauma Care
Surg Clin North Am. 2024 Apr;104(2):267-277. doi: 10.1016/j.suc.2023.10.005. Epub 2023 Nov 18.ABSTRACTPrehospital trauma evaluation begins with the primary assessment of airway, breathing, circulation, disability, and exposure. This is closely followed by vital signs and a secondary assessment. Key prehospital interventions include management and resuscitation according to the aforementioned principles with a focus on major hemorrhage control, airway compromise, and invasive management of tension pneumothorax. Determining the appropriate time and method for transportation (eg, ground ambulance, helicopter, police, private ...
Source: The Surgical Clinics of North America - March 7, 2024 Category: Surgery Authors: Christopher M Wend Ryan B Fransman Elliott R Haut Source Type: research

Resuscitation and Care in the Trauma Bay
Surg Clin North Am. 2024 Apr;104(2):279-292. doi: 10.1016/j.suc.2023.09.005. Epub 2023 Oct 20.ABSTRACTStart balanced resuscitation early (pre-hospital if possible), either in the form of whole blood or 1:1:1 ratio. Minimize resuscitation with crystalloid to minimize patient morbidity and mortality. Trauma-induced coagulopathy can be largely avoided with the use of balanced resuscitation, permissive hypotension, and minimized time to hemostasis. Using protocolized "triggers" for massive and ultramassive transfusion will assist in minimizing delays in transfusion of products, achieving balanced ratios, and avoiding trauma in...
Source: The Surgical Clinics of North America - March 7, 2024 Category: Surgery Authors: Jan-Michael Van Gent Thomas W Clements Bryan A Cotton Source Type: research

Trauma Bay Evaluation and Resuscitative Decision-Making
Surg Clin North Am. 2024 Apr;104(2):293-309. doi: 10.1016/j.suc.2024.01.002.ABSTRACTThe reader of this article will now have the ability to reflect on all aspects of high-quality trauma bay care, from resuscitation to diagnosis and leadership to debriefing. Although there is no replacement for experience, both clinically and in a simulation environment, trauma clinicians are encouraged to make use of this article both as a primer at the beginning of a trauma rotation and a reference text to revisit after difficult cases in the trauma bay. Also, periods of reflection seem appropriate in the busy but, of course, rewarding ca...
Source: The Surgical Clinics of North America - March 7, 2024 Category: Surgery Authors: William Robert Leeper Nicholas James Source Type: research

The Role of Resuscitative Endovascular Balloon Occlusion of the Aorta
Surg Clin North Am. 2024 Apr;104(2):311-323. doi: 10.1016/j.suc.2024.01.003. Epub 2024 Feb 15.ABSTRACTResuscitative endovascular balloon occlusion of the aorta (REBOA) has been utilized by trauma surgeons at the bedside for over a decade in both civilian and military settings. Both translational and clinical research suggest it is superior to resuscitative thoracotomy for specific patient populations. Technological advancements in recent years have significantly enhanced the safety profile of REBOA. Resuscitative balloon occlusion of the aorta has also swiftly found implementation in patients in shock from non-traumatic he...
Source: The Surgical Clinics of North America - March 7, 2024 Category: Surgery Authors: Megan Brenner Source Type: research

Management of Head Trauma
Surg Clin North Am. 2024 Apr;104(2):325-341. doi: 10.1016/j.suc.2023.09.006. Epub 2023 Oct 21.ABSTRACTTraumatic brain injury (TBI) represents a heterogenous spectrum of disease. It is essential to rapidly assess a patient's neurologic status and implement measures to prevent secondary brain injury. Intracranial hypertension, a common sequela of TBI, is managed in a tiered and systematic fashion, starting with the least invasive and moving toward the most invasive. TBI has long-lasting effects on patients and their families and represents a substantial financial and social influence on society. Research regarding the progno...
Source: The Surgical Clinics of North America - March 7, 2024 Category: Surgery Authors: Deborah Stein Meaghan Broderick Source Type: research

Management of Blunt Chest Trauma
Surg Clin North Am. 2024 Apr;104(2):343-354. doi: 10.1016/j.suc.2023.09.007. Epub 2023 Oct 29.ABSTRACTCommon mechanisms of blunt thoracic injury include motor vehicle collisions and falls. Chest wall injuries include rib fractures and sternal fractures; treatment involves supportive care, multimodal analgesia, and pulmonary toilet. Pneumothorax, hemothorax, and pulmonary contusions are also common and may be managed expectantly or with tube thoracostomy as indicated. Surgical treatment may be considered in select cases. Less common injury patterns include blunt trauma to the tracheobronchial tree, esophagus, diaphragm, hea...
Source: The Surgical Clinics of North America - March 7, 2024 Category: Surgery Authors: Jared Griffard Lisa M Kodadek Source Type: research

Damage Control Laparotomy and Management of the Open Abdomen
Surg Clin North Am. 2024 Apr;104(2):355-366. doi: 10.1016/j.suc.2023.09.008. Epub 2023 Oct 20.ABSTRACTManagement of the open abdomen has been used for decades by general surgeons. Techniques have evolved over those decades to improve control of infection, fluid loss, and improve the ability to close the abdomen to avoid hernia formation. The authors explore the history, indications, and techniques of open abdomen management in multiple settings. The most important considerations in open abdomen management include the reason for leaving the abdomen open, prevention and mitigation of ongoing organ dysfunction, and eventual p...
Source: The Surgical Clinics of North America - March 7, 2024 Category: Surgery Authors: Jennifer Serfin Christopher Dai James Reece Harris Nathan Smith Source Type: research

Management of Pelvic Trauma
Surg Clin North Am. 2024 Apr;104(2):367-384. doi: 10.1016/j.suc.2023.10.001. Epub 2023 Nov 22.ABSTRACTPelvic fractures are common after blunt trauma with patients' presentation ranging from stable with insignificant fractures to life-threatening exsanguination from unstable fractures. Often, hemorrhagic shock from a pelvic fracture may go unrecognized and high clinical suspicion for a pelvic source lies with the clinician. A multidisciplinary coordinated effort is required for management of these complex patients. In the exsanguinating patient, hemorrhage control remains the top priority and may be achieved with external s...
Source: The Surgical Clinics of North America - March 7, 2024 Category: Surgery Authors: Jennifer E Baker Nicole L Werner Clay Cothren Burlew Source Type: research

Management of the Mangled Extremity
Surg Clin North Am. 2024 Apr;104(2):385-404. doi: 10.1016/j.suc.2023.10.006. Epub 2023 Nov 17.ABSTRACTMangled extremities represent one of the most challenging injuries. They indicate the need for a comprehensive trauma assessment to rule out coexisting injuries. Treatment options include amputation and attempts at limb salvage. Although both have been associated with chronic disability, new surgical techniques and evolving rehabilitation options offer hope for the future.PMID:38453309 | DOI:10.1016/j.suc.2023.10.006 (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - March 7, 2024 Category: Surgery Authors: Erin Farrelly Rae Tarapore Sierra Lindsey Mark D Wieland Source Type: research

Nutritional Support in Critically Ill Trauma Patients
Surg Clin North Am. 2024 Apr;104(2):405-421. doi: 10.1016/j.suc.2023.10.002. Epub 2023 Nov 7.ABSTRACTEnteral nutrition should be initiated within 24 to 48 hours of injury, starting at a trophic rate and increasing to goal rate after hemodynamic stability is achieved. The modified Nutritional Risk in the Critically Ill score can help identify patients who will benefit most from aggressive and early nutritional intervention. In the first week of critical illness, the patient should receive only 70% to 80% of estimated calories and protein should be targeted to 1.5 to 2 g/kg. Parenteral nutrition can be provided safely withou...
Source: The Surgical Clinics of North America - March 7, 2024 Category: Surgery Authors: Renaldo Williams Daniel Dante Yeh Source Type: research

Management of the Geriatric Trauma Patient
Surg Clin North Am. 2024 Apr;104(2):423-436. doi: 10.1016/j.suc.2023.09.010. Epub 2023 Oct 20.ABSTRACTWith a rapidly aging worldwide population, the care of geriatric trauma patients will be at the forefront of every career in Trauma and Acute Care Surgery. The unique intersection of advanced age, comorbidities, frailty, and physiologic changes presents a challenge in the care of elderly injured patients. It is well established that increasing age is associated with higher mortality and worse outcomes after injury, but it is also clear that there is room for improvement in the management of this special patient population....
Source: The Surgical Clinics of North America - March 7, 2024 Category: Surgery Authors: Megan Elizabeth Lundy Bo Zhang Michael Ditillo Source Type: research

The Role of Minimally Invasive Surgeries in Trauma
This article delves into the role of minimally invasive surgeries in trauma, specifically laparoscopy and video-assisted thoracic surgery (VATS). It discusses the benefits of laparoscopy over traditional laparotomy, including its accuracy in detecting peritoneal violation and intraperitoneal injuries caused by penetrating trauma. The article also explores the use of laparoscopy as an adjunct to nonoperative management of abdominal injuries and in cases of blunt trauma with unclear abdominal injuries. Furthermore, it highlights the benefits of VATS in diagnosing and treating thoracic injuries, such as traumatic diaphragmati...
Source: The Surgical Clinics of North America - March 7, 2024 Category: Surgery Authors: Atif Jastaniah Jeremey Grushka Source Type: research

Teaching Before, During, and After a Surgical Resuscitation
Surg Clin North Am. 2024 Apr;104(2):451-471. doi: 10.1016/j.suc.2023.10.004. Epub 2023 Oct 28.ABSTRACTTeaching during a surgical resuscitation can be difficult due to the infrequency of these events. Furthermore, when these events do occur, the trainee can experience cognitive overload and an overwhelming amount of stress, thereby impairing the learning process. The emergent nature of these scenarios can make it difficult for the surgical educator to adequately teach. Repeated exposure through simulation, role play, and "war games" are great adjuncts to teaching and preparation before crisis. However, surgical educators ca...
Source: The Surgical Clinics of North America - March 7, 2024 Category: Surgery Authors: Paul J Schenarts Alec J Scarborough Ren J Abraham George Philip Source Type: research