Current Trauma Reports最新文献

Purpose of review: Complicated diverticulitis is a common gastrointestinal pathology. Historically, surgical management involved multi-stage open resection and stoma creation, which were often associated with more significant morbidity, low stoma reversal rates, and postoperative complications.

Recent findings: Minimally invasive techniques, including laparoscopy and robotics, have emerged as alternative options for surgically managing complicated diverticulitis. While high conversion rates may deter surgeons from minimally invasive approaches, robotics offer several technical advantages, including three-dimensional visualization, increased instrument range of motion, reduced conversion rates compared to laparoscopy, and improved postoperative patient outcomes.

Summary: In this review, we discuss robotic surgery as a safe and feasible approach to the surgical management of complicated diverticulitis both electively and emergently in select patients. We present recommendations for intraoperative robotics setup and patient positioning and propose solutions that address the limitations of robotics, such as longer operative times and specialized training, that affect the adoption of robotics for surgically managing complicated diverticulitis.

Purpose of review: Motor vehicle crashes are the leading cause of death among those less than 54 years old in the United States. From the genesis of automobile transportation, significant efforts to improve crash safety technology standards and traffic laws have been made. Despite these attempts, in 2021, the motor vehicle fatality rate increased by 10.5%, leading some to question the effectiveness of recent efforts. This critical review aims to discuss the history of motor vehicle technologic and legislative advancements, data investigating effectiveness, and opportunity for future improvement.

Recent findings: Collective transition to primary seatbelt laws, advancement of airbag design, implementation of driver assist technologies, as well as stricter alcohol legislation may offer response to the recent increase in motor vehicle fatalities.

Summary: A coordinated effort for change from automobile manufacturers, drivers, law enforcement, and local/federal governments will be required to address the recent increase in motor vehicle fatalities.

Purpose of review: We review the vocabulary and studies regarding stress disorders, as it relates to trauma care providers, specifically trauma surgeons. In addition, we make recommendations regarding strategies to address the needs identified and future areas of research to assess the adequacy of these strategies.

Recent findings: Stress disorders in trauma are common and constant, identified at levels similar to those seen among first-responders to mass-casualty events. These disorders are identified at every level-from trainee to the most experienced. Trauma surgeons experience the trauma firsthand, as well as through forced re-traumatization as a part of routine care. High levels of cumulative stress result due to the volume of patients that can be difficult to process due to the frequency of shifts and disrupted sleep patterns. This level of chronic stress can lead to a cycle of burnout and increased stress, which is harmful to surgeons and patients.

Summary: Stress disorders are common and poorly understood. Treatment options are infrequently encountered. In order to more adequately respond to this, systematic change is necessary.