Pub Date : 2024-04-10DOI: 10.1097/ta.0000000000004341
Joshua Dilday, Patrick McGillen, Stephen Park, Shea Gallagher, Heewon Lee, Morgan Schellenberg, Kazuhide Matsushima, Kenji Inaba, Matthew J Martin
Emergent laparotomy is associated with significant wound complications including surgical site infections (SSI) and fascial dehiscence (FD). Triclosan-coated barbed suture (TCB) for fascial closure has been shown to reduce local complications but primarily in elective settings. We sought to evaluate the effect of TCB emergency laparotomy fascial closure on major wound complications.
{"title":"Is Barbed Better? Evaluation of Triclosan-Coated Barbed Suture on Wound Complications Following Emergency Laparotomy.","authors":"Joshua Dilday, Patrick McGillen, Stephen Park, Shea Gallagher, Heewon Lee, Morgan Schellenberg, Kazuhide Matsushima, Kenji Inaba, Matthew J Martin","doi":"10.1097/ta.0000000000004341","DOIUrl":"https://doi.org/10.1097/ta.0000000000004341","url":null,"abstract":"Emergent laparotomy is associated with significant wound complications including surgical site infections (SSI) and fascial dehiscence (FD). Triclosan-coated barbed suture (TCB) for fascial closure has been shown to reduce local complications but primarily in elective settings. We sought to evaluate the effect of TCB emergency laparotomy fascial closure on major wound complications.","PeriodicalId":501845,"journal":{"name":"The Journal of Trauma and Acute Care Surgery","volume":"89 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140572413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-10DOI: 10.1097/ta.0000000000004337
Anupamaa Seshadri, Andrew B Peitzman
This review discusses the grading of cholecystitis, the optimal timing of cholecystectomy, adopting a culture of safe cholecystectomy, understanding the common error traps that can lead to intraoperative complications and how to avoid them. The Tokyo Guidelines, AAST, Nassar and Parkland scoring systems are discussed. The patient factors, physiologic status and operative findings that predict a difficult cholecystectomy or conversion from laparoscopic to open cholecystectomy are reviewed. With laparoscopic expertise and patient conditions that are not prohibitive, early laparoscopic cholecystectomy is recommended. This is ideally within 72 hours of admission but supported up to the seventh hospital day. The majority of bile duct injuries (BDI) are due to misidentification of normal anatomy. Strasberg's four error traps and the zones of danger to avoid during a cholecystectomy are described. The review emphasizes the importance of a true critical view of safety (CVS) for identification of the anatomy. In up to 15% of operations for acute cholecystitis, a CVS cannot be achieved safely. Recognizing these conditions and changing your operative strategy are mandatory to avoid harm. The principles to follow for a safe cholecystectomy are discussed in detail. The cardinal message of this review is "under challenging conditions, BDI can be minimized via either a subtotal cholecystectomy or top-down cholecystectomy if dissection in the hepatocystic triangle is avoided." (28) The most severe biliary/vascular injuries usually occur after conversion from laparoscopic cholecystectomy. Indications and techniques for bailout procedures including the fenestrating and reconstituting subtotal cholecystectomy are presented. Seven to ten percent of cholecystectomies for acute cholecystitis currently result in subtotal cholecystectomy.
{"title":"The Difficult Cholecystectomy: What You Need to Know.","authors":"Anupamaa Seshadri, Andrew B Peitzman","doi":"10.1097/ta.0000000000004337","DOIUrl":"https://doi.org/10.1097/ta.0000000000004337","url":null,"abstract":"This review discusses the grading of cholecystitis, the optimal timing of cholecystectomy, adopting a culture of safe cholecystectomy, understanding the common error traps that can lead to intraoperative complications and how to avoid them. The Tokyo Guidelines, AAST, Nassar and Parkland scoring systems are discussed. The patient factors, physiologic status and operative findings that predict a difficult cholecystectomy or conversion from laparoscopic to open cholecystectomy are reviewed. With laparoscopic expertise and patient conditions that are not prohibitive, early laparoscopic cholecystectomy is recommended. This is ideally within 72 hours of admission but supported up to the seventh hospital day. The majority of bile duct injuries (BDI) are due to misidentification of normal anatomy. Strasberg's four error traps and the zones of danger to avoid during a cholecystectomy are described. The review emphasizes the importance of a true critical view of safety (CVS) for identification of the anatomy. In up to 15% of operations for acute cholecystitis, a CVS cannot be achieved safely. Recognizing these conditions and changing your operative strategy are mandatory to avoid harm. The principles to follow for a safe cholecystectomy are discussed in detail. The cardinal message of this review is \"under challenging conditions, BDI can be minimized via either a subtotal cholecystectomy or top-down cholecystectomy if dissection in the hepatocystic triangle is avoided.\" (28) The most severe biliary/vascular injuries usually occur after conversion from laparoscopic cholecystectomy. Indications and techniques for bailout procedures including the fenestrating and reconstituting subtotal cholecystectomy are presented. Seven to ten percent of cholecystectomies for acute cholecystitis currently result in subtotal cholecystectomy.","PeriodicalId":501845,"journal":{"name":"The Journal of Trauma and Acute Care Surgery","volume":"149 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140572406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-10DOI: 10.1097/ta.0000000000004278
Seema P Anandalwar, Lindsay O'Meara, Roumen Vesselinov, Ashling Zhang, Jeffrey N Baum, Amanda Cooper, Cassandra Decker, Thomas Schroeppel, Jenny Cai, Daniel Cullinane, Richard D Catalano, Nikolay Bugaev, Madison LeClair, Christina Feather, Katherine McBride, Valerie Sams, Pak Shan Leung, Samantha Olafson, Devon S Callahan, Joseph Posluszny, Simon Moradian, Jordan Estroff, Beth Hochman, Natasha Coleman, Anna Goldenberg-Sandau, Jeffry Nahmias, Kathryn Rosenbaum, Jason Pasley, Lindsay Boll, Leah Hustad, Jessica Reynolds, Michael Truitt, Mira Ghneim
To assess perioperative bleeding complications & in-hospital mortality in patients requiring emergency general surgery (EGS) presenting with a history of antiplatelet (AP) vs. direct oral anticoagulant (DOAC) vs warfarin use.
{"title":"Warfarin, not direct oral anticoagulants nor antiplatelet therapy, is associated with increased bleeding risk in emergency general surgery patients: implications in this new era of novel anticoagulants: An EAST Multicenter study.","authors":"Seema P Anandalwar, Lindsay O'Meara, Roumen Vesselinov, Ashling Zhang, Jeffrey N Baum, Amanda Cooper, Cassandra Decker, Thomas Schroeppel, Jenny Cai, Daniel Cullinane, Richard D Catalano, Nikolay Bugaev, Madison LeClair, Christina Feather, Katherine McBride, Valerie Sams, Pak Shan Leung, Samantha Olafson, Devon S Callahan, Joseph Posluszny, Simon Moradian, Jordan Estroff, Beth Hochman, Natasha Coleman, Anna Goldenberg-Sandau, Jeffry Nahmias, Kathryn Rosenbaum, Jason Pasley, Lindsay Boll, Leah Hustad, Jessica Reynolds, Michael Truitt, Mira Ghneim","doi":"10.1097/ta.0000000000004278","DOIUrl":"https://doi.org/10.1097/ta.0000000000004278","url":null,"abstract":"To assess perioperative bleeding complications & in-hospital mortality in patients requiring emergency general surgery (EGS) presenting with a history of antiplatelet (AP) vs. direct oral anticoagulant (DOAC) vs warfarin use.","PeriodicalId":501845,"journal":{"name":"The Journal of Trauma and Acute Care Surgery","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140572165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-10DOI: 10.1097/ta.0000000000004356
Jotaro Tachino, Yuki Togami, Hisatake Matsumoto, Tsunehiro Matsubara, Shigeto Seno, Hiroshi Ogura, Jun Oda
Trauma-related deaths and post-traumatic sequelae are a global health concern, necessitating a deeper understanding of the pathophysiology to advance trauma therapy. Proteomics offers insights into identifying and analyzing plasma proteins associated with trauma and inflammatory conditions; however, current proteomic methods have limitations in accurately measuring low-abundance plasma proteins. This study compared plasma proteomics profiles of patients from different acute trauma subgroups to identify new therapeutic targets and devise better strategies for personalized medicine.
{"title":"Plasma Proteomics Profile-Based Comparison of Torso Versus Brain Injury: A Prospective Cohort Study.","authors":"Jotaro Tachino, Yuki Togami, Hisatake Matsumoto, Tsunehiro Matsubara, Shigeto Seno, Hiroshi Ogura, Jun Oda","doi":"10.1097/ta.0000000000004356","DOIUrl":"https://doi.org/10.1097/ta.0000000000004356","url":null,"abstract":"Trauma-related deaths and post-traumatic sequelae are a global health concern, necessitating a deeper understanding of the pathophysiology to advance trauma therapy. Proteomics offers insights into identifying and analyzing plasma proteins associated with trauma and inflammatory conditions; however, current proteomic methods have limitations in accurately measuring low-abundance plasma proteins. This study compared plasma proteomics profiles of patients from different acute trauma subgroups to identify new therapeutic targets and devise better strategies for personalized medicine.","PeriodicalId":501845,"journal":{"name":"The Journal of Trauma and Acute Care Surgery","volume":"451 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140572275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-08DOI: 10.1097/ta.0000000000004335
James Bardes, Daniel Grabo, Aaron Shmookler, Sijin Wen, Alison Wilson
In order to improve rural and austere trauma care, hospital-based testing performed at the point of injury may shorten the time lapsed from injury to intervention. This study aimed to evaluate the use of the TEG6s® device in a rotary wing aircraft. Prior attempts suffered from limitation related to lack of vibration mitigation.
{"title":"Investigation and Validation of the TEG6s During Rotary Wing Aeromedical Flight.","authors":"James Bardes, Daniel Grabo, Aaron Shmookler, Sijin Wen, Alison Wilson","doi":"10.1097/ta.0000000000004335","DOIUrl":"https://doi.org/10.1097/ta.0000000000004335","url":null,"abstract":"In order to improve rural and austere trauma care, hospital-based testing performed at the point of injury may shorten the time lapsed from injury to intervention. This study aimed to evaluate the use of the TEG6s® device in a rotary wing aircraft. Prior attempts suffered from limitation related to lack of vibration mitigation.","PeriodicalId":501845,"journal":{"name":"The Journal of Trauma and Acute Care Surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140572178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-08DOI: 10.1097/ta.0000000000004330
Elissa Abou Khalil, Erin Feeney, Katrina M Morgan, Philip C Spinella, Barbara A Gaines, Christine M Leeper
Admission hypocalcemia has been associated with poor outcomes in injured adults. The impact of hypocalcemia on mortality has not been widely studied in pediatric trauma.
入院时的低钙血症与成人伤者的不良预后有关。低钙血症对儿科创伤死亡率的影响尚未得到广泛研究。
{"title":"Impact of hypocalcemia on mortality in pediatric trauma patients who require transfusion.","authors":"Elissa Abou Khalil, Erin Feeney, Katrina M Morgan, Philip C Spinella, Barbara A Gaines, Christine M Leeper","doi":"10.1097/ta.0000000000004330","DOIUrl":"https://doi.org/10.1097/ta.0000000000004330","url":null,"abstract":"Admission hypocalcemia has been associated with poor outcomes in injured adults. The impact of hypocalcemia on mortality has not been widely studied in pediatric trauma.","PeriodicalId":501845,"journal":{"name":"The Journal of Trauma and Acute Care Surgery","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140572139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-08DOI: 10.1097/TA.0000000000004350
Amy J Goldberg
{"title":"I Would Not Change a Thing!","authors":"Amy J Goldberg","doi":"10.1097/TA.0000000000004350","DOIUrl":"https://doi.org/10.1097/TA.0000000000004350","url":null,"abstract":"","PeriodicalId":501845,"journal":{"name":"The Journal of Trauma and Acute Care Surgery","volume":"37 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140732237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1097/ta.0000000000004336
Pierre Pasquier, Mathieu David, Ludovic Petit, Morgan Chery, Sébastien Habas, Edouard Patey, Sébastien Conort, Nicolas Zeller, Marc-Olivier Gelmann, Sébastien Peyrefitte, Fabrice Castel, Stéphane Travers, Pierre Mahé
Military operations are no longer limited to the application of counterterrorism and counterinsurgency strategies; they are now characterized by hybrid, irregular, and unconventional features. While some authors have indicated the need for medical support to adapt to these new modes of military operations, they have focused mainly on the tactical level of care on the battlefield. As Sun Tzu states, "Strategy without tactics is the slowest route to victory. Tactics without strategy is the noise before defeat," further proposals are still needed on the application of both medical tactics and medical strategies in irregular warfare.
{"title":"Irregular Warfare Must Combine Good Medicine, with Both Good Tactics and Good Strategies: Position Paper by the French Special Operations Forces Medical Command.","authors":"Pierre Pasquier, Mathieu David, Ludovic Petit, Morgan Chery, Sébastien Habas, Edouard Patey, Sébastien Conort, Nicolas Zeller, Marc-Olivier Gelmann, Sébastien Peyrefitte, Fabrice Castel, Stéphane Travers, Pierre Mahé","doi":"10.1097/ta.0000000000004336","DOIUrl":"https://doi.org/10.1097/ta.0000000000004336","url":null,"abstract":"Military operations are no longer limited to the application of counterterrorism and counterinsurgency strategies; they are now characterized by hybrid, irregular, and unconventional features. While some authors have indicated the need for medical support to adapt to these new modes of military operations, they have focused mainly on the tactical level of care on the battlefield. As Sun Tzu states, \"Strategy without tactics is the slowest route to victory. Tactics without strategy is the noise before defeat,\" further proposals are still needed on the application of both medical tactics and medical strategies in irregular warfare.","PeriodicalId":501845,"journal":{"name":"The Journal of Trauma and Acute Care Surgery","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140572176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-19DOI: 10.1097/ta.0000000000004231
Fabio Agri, Basile Pache, Mylène Bourgeat, Vincent Darioli, Nicolas Demartines, Sabine Schmidt, Tobias Zingg
Avoiding missed diagnosis and therapeutic delay for significant blunt bowel and mesenteric injuries (sBBMI) after trauma is still challenging despite the widespread use of computed tomography. Several scoring tools aiming at reducing this risk have been published. The purpose of the present work was to assess the incidence of delayed (>24 h) diagnosis for sBBMI patients and to compare the predictive performance of three previously published scores using clinical, radiological and laboratory findings: the "Bowel Injury Prediction Score" (BIPS) and the scores developed by Raharimanantsoa (RS) and by Faget (FS).
{"title":"Performance of three predictive scores to avoid delayed diagnosis of significant blunt bowel and mesenteric injury. A 12-year retrospective cohort study.","authors":"Fabio Agri, Basile Pache, Mylène Bourgeat, Vincent Darioli, Nicolas Demartines, Sabine Schmidt, Tobias Zingg","doi":"10.1097/ta.0000000000004231","DOIUrl":"https://doi.org/10.1097/ta.0000000000004231","url":null,"abstract":"Avoiding missed diagnosis and therapeutic delay for significant blunt bowel and mesenteric injuries (sBBMI) after trauma is still challenging despite the widespread use of computed tomography. Several scoring tools aiming at reducing this risk have been published. The purpose of the present work was to assess the incidence of delayed (>24 h) diagnosis for sBBMI patients and to compare the predictive performance of three previously published scores using clinical, radiological and laboratory findings: the \"Bowel Injury Prediction Score\" (BIPS) and the scores developed by Raharimanantsoa (RS) and by Faget (FS).","PeriodicalId":501845,"journal":{"name":"The Journal of Trauma and Acute Care Surgery","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138743801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-18DOI: 10.1097/ta.0000000000004233
Federico Coccolini, Massimo Sartelli, Robert Sawyer, Kemal Rasa, Marco Ceresoli, Bruno Viaggi, Fausto Catena, Dimitrios Damaskos, Enrico Cicuttin, Camilla Cremonini, Ernest E Moore, Walter L Biffl, Raul Coimbra
Trauma is a complex disease, and the use of antibiotic prophylaxis (AP) in trauma patients is common practice. However, considering the increasing rates of antibiotic resistance, AP use should be questioned and limited only to specific cases. Antibiotic stewardship is of paramount importance in fighting resistance spread. Definitive rules or precise indications about antibiotic prophylaxis in trauma remain unclear. The present manuscript describes the indications of antibiotic prophylaxis in traumatic lesions to the head, brain, torso, maxillo-facial, extremities, skin, and soft tissues endorsed by the Global Alliance for Infection in Surgery (GAIS), Surgical Infection Society Europe (SIS-E), World Surgical Infection Society (WSIS), American Association for the Surgery of Trauma (AAST), World Society of Emergency Surgery (WSES).
{"title":"Antibiotic prophylaxis in trauma: GAIS, SIS-E, WSIS, AAST, WSES guidelines.","authors":"Federico Coccolini, Massimo Sartelli, Robert Sawyer, Kemal Rasa, Marco Ceresoli, Bruno Viaggi, Fausto Catena, Dimitrios Damaskos, Enrico Cicuttin, Camilla Cremonini, Ernest E Moore, Walter L Biffl, Raul Coimbra","doi":"10.1097/ta.0000000000004233","DOIUrl":"https://doi.org/10.1097/ta.0000000000004233","url":null,"abstract":"Trauma is a complex disease, and the use of antibiotic prophylaxis (AP) in trauma patients is common practice. However, considering the increasing rates of antibiotic resistance, AP use should be questioned and limited only to specific cases. Antibiotic stewardship is of paramount importance in fighting resistance spread. Definitive rules or precise indications about antibiotic prophylaxis in trauma remain unclear. The present manuscript describes the indications of antibiotic prophylaxis in traumatic lesions to the head, brain, torso, maxillo-facial, extremities, skin, and soft tissues endorsed by the Global Alliance for Infection in Surgery (GAIS), Surgical Infection Society Europe (SIS-E), World Surgical Infection Society (WSIS), American Association for the Surgery of Trauma (AAST), World Society of Emergency Surgery (WSES).","PeriodicalId":501845,"journal":{"name":"The Journal of Trauma and Acute Care Surgery","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138745918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}