Pub Date : 2024-05-01DOI: 10.14744/tjtes.2023.05118
Fatih Ceran, Mehmet Bozkurt, Salih Onur Basat, Emin Kapi
Background: Various reconstructive options exist for distal finger and pulp defects, including grafting and local or distant flaps. In addition to reconstructing the normal anatomical structure, preserving the sensory function of the finger is crucial. This study presents the results of using bone grafting combined with a spiral flap (BGcSF) technique for reconstructing pulp defects accompanied by bone loss.
Methods: Twenty-three patients with fingertip defects were treated using the BGcSF technique. Flap sensitivity was assessed us-ing the Semmes-Weinstein monofilament (SWM) and static two-point discrimination (2PD) tests at six months postoperatively. Cold intolerance of the affected fingers was evaluated using the Cold Intolerance Severity Score (CISS) questionnaire at one year postop-eratively. Patient satisfaction was assessed using the Michigan Hand Outcomes Questionnaire (MHQ). Range of motion (ROM) for the proximal and distal interphalangeal joints was measured with a goniometer at one year postoperatively.
Results: Distal flap necrosis, affecting 10-15% of the flap area, was observed in one patient. No other complications were noted. The mean static two-point discrimination value at six months postoperatively was 5.6 mm, and the mean SWM score was 3.56. The mean CISS score at one year postoperatively was 18.8. The mean active ROM angle for the proximal interphalangeal joint was 106.7 degrees, and for the distal interphalangeal joint, it was 65.4 degrees. The mean MHQ score at one year postoperatively was 18.5.
Conclusion: The BGcSF technique provides soft tissue with a texture similar to that of the fingertips and supports effective sensory repair. It can be considered a viable option for fingertip reconstruction in cases where replantation is not feasible.
背景:针对手指远端和牙髓缺损有多种重建方案,包括移植和局部或远端皮瓣。除了重建正常的解剖结构外,保留手指的感觉功能也至关重要。本研究介绍了使用植骨结合螺旋皮瓣(BGcSF)技术重建伴有骨质流失的牙髓缺损的结果:方法:采用 BGcSF 技术治疗了 23 名指尖缺损患者。术后六个月,使用塞姆斯-韦恩斯坦单丝(SWM)和静态两点辨别(2PD)测试评估了皮瓣敏感性。术后一年时,使用不耐寒严重程度评分(CISS)问卷评估患指的不耐寒程度。患者满意度采用密歇根手部结果问卷(MHQ)进行评估。术后一年,用测角器测量近端和远端指间关节的活动范围(ROM):结果:观察到一名患者的远端皮瓣坏死,影响皮瓣面积的10-15%。未发现其他并发症。术后六个月的平均静态两点辨别值为 5.6 mm,平均 SWM 得分为 3.56。术后一年的平均CISS评分为18.8分。近端指间关节的平均主动 ROM 角度为 106.7 度,远端指间关节的平均主动 ROM 角度为 65.4 度。术后一年的平均MHQ评分为18.5分:结论:BGcSF 技术可提供与指尖质地相似的软组织,并支持有效的感觉修复。结论:BGcSF 技术可提供质地与指尖相似的软组织,并支持有效的感觉修复,在无法进行再植的情况下,它可被视为指尖重建的可行方案。
{"title":"Bone grafting combined with a spiral flap technique for the reconstruction of fingertip amputations.","authors":"Fatih Ceran, Mehmet Bozkurt, Salih Onur Basat, Emin Kapi","doi":"10.14744/tjtes.2023.05118","DOIUrl":"10.14744/tjtes.2023.05118","url":null,"abstract":"<p><strong>Background: </strong>Various reconstructive options exist for distal finger and pulp defects, including grafting and local or distant flaps. In addition to reconstructing the normal anatomical structure, preserving the sensory function of the finger is crucial. This study presents the results of using bone grafting combined with a spiral flap (BGcSF) technique for reconstructing pulp defects accompanied by bone loss.</p><p><strong>Methods: </strong>Twenty-three patients with fingertip defects were treated using the BGcSF technique. Flap sensitivity was assessed us-ing the Semmes-Weinstein monofilament (SWM) and static two-point discrimination (2PD) tests at six months postoperatively. Cold intolerance of the affected fingers was evaluated using the Cold Intolerance Severity Score (CISS) questionnaire at one year postop-eratively. Patient satisfaction was assessed using the Michigan Hand Outcomes Questionnaire (MHQ). Range of motion (ROM) for the proximal and distal interphalangeal joints was measured with a goniometer at one year postoperatively.</p><p><strong>Results: </strong>Distal flap necrosis, affecting 10-15% of the flap area, was observed in one patient. No other complications were noted. The mean static two-point discrimination value at six months postoperatively was 5.6 mm, and the mean SWM score was 3.56. The mean CISS score at one year postoperatively was 18.8. The mean active ROM angle for the proximal interphalangeal joint was 106.7 degrees, and for the distal interphalangeal joint, it was 65.4 degrees. The mean MHQ score at one year postoperatively was 18.5.</p><p><strong>Conclusion: </strong>The BGcSF technique provides soft tissue with a texture similar to that of the fingertips and supports effective sensory repair. It can be considered a viable option for fingertip reconstruction in cases where replantation is not feasible.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11154071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Magnet ingestion in children can lead to serious complications, both acutely and chronically. This case report discusses the treatment approach for a case involving multiple magnet ingestions, which resulted in a jejuno-colonic fistula, segmental intestinal volvulus, hepa-tosteatosis, and renal calculus detected at a late stage. Additionally, we conducted a literature review to explore the characteristics of intestinal fistulas caused by magnet ingestion. A six-year-old girl was admitted to the Pediatric Gastroenterology Department pre-senting with intermittent abdominal pain, vomiting, and diarrhea persisting for two years. Initial differential diagnoses included celiac disease, cystic fibrosis, inflammatory bowel disease, and tuberculosis, yet the etiology remained elusive. The Pediatric Surgery team was consulted after a jejuno-colonic fistula was suspected based on magnetic resonance imaging findings. The physical examination revealed no signs of acute abdomen but showed mild abdominal distension. Subsequent upper gastrointestinal series and contrast enema graphy confirmed a jejuno-colonic fistula and segmental volvulus. The family later reported that the child had swallowed a magnet two years prior, and medical follow-up had stopped after the spontaneous expulsion of the magnets within one to two weeks. Surgical intervention was necessary to correct the volvulus and repair the large jejuno-colonic fistula. To identify relevant studies, we conducted a detailed literature search on magnet ingestion and gastrointestinal fistulas according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We identified 44 articles encompassing 55 cases where symptoms did not manifest in the acute phase and acute abdomen was not observed. In 29 cases, the time of magnet ingestion was unknown. Among the 26 cases with a known ingestion time, the average duration until fistula detection was 22.8 days (range: 1-90 days). Fistula repairs were performed via laparotomy in 47 cases.
{"title":"Chronic jejuno-colonic fistula and intestinal malabsorption due to multiple magnet ingestions: A case report and systematic review.","authors":"Rahşan Özcan, Ali Ekber Hakalmaz, Ayşe Kalyoncu Uçar, Omer Beser, Senol Emre","doi":"10.14744/tjtes.2024.50845","DOIUrl":"10.14744/tjtes.2024.50845","url":null,"abstract":"<p><p>Magnet ingestion in children can lead to serious complications, both acutely and chronically. This case report discusses the treatment approach for a case involving multiple magnet ingestions, which resulted in a jejuno-colonic fistula, segmental intestinal volvulus, hepa-tosteatosis, and renal calculus detected at a late stage. Additionally, we conducted a literature review to explore the characteristics of intestinal fistulas caused by magnet ingestion. A six-year-old girl was admitted to the Pediatric Gastroenterology Department pre-senting with intermittent abdominal pain, vomiting, and diarrhea persisting for two years. Initial differential diagnoses included celiac disease, cystic fibrosis, inflammatory bowel disease, and tuberculosis, yet the etiology remained elusive. The Pediatric Surgery team was consulted after a jejuno-colonic fistula was suspected based on magnetic resonance imaging findings. The physical examination revealed no signs of acute abdomen but showed mild abdominal distension. Subsequent upper gastrointestinal series and contrast enema graphy confirmed a jejuno-colonic fistula and segmental volvulus. The family later reported that the child had swallowed a magnet two years prior, and medical follow-up had stopped after the spontaneous expulsion of the magnets within one to two weeks. Surgical intervention was necessary to correct the volvulus and repair the large jejuno-colonic fistula. To identify relevant studies, we conducted a detailed literature search on magnet ingestion and gastrointestinal fistulas according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We identified 44 articles encompassing 55 cases where symptoms did not manifest in the acute phase and acute abdomen was not observed. In 29 cases, the time of magnet ingestion was unknown. Among the 26 cases with a known ingestion time, the average duration until fistula detection was 22.8 days (range: 1-90 days). Fistula repairs were performed via laparotomy in 47 cases.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11154068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.14744/tjtes.2024.00569
Bedih Balkan, Zahide Özlem Ulubay, Elif Güneysu, Ahmet Said Dündar, Engin Ihsan Turan
Background: This study aims to identify the factors influencing 30-day morbidity and mortality in patients aged 65 and older undergoing cardiovascular surgery.
Methods: Data from 360 patients who underwent cardiac surgery between January 2012 and August 2021 in the Cardiovascular Surgery Intensive Care Unit (CVS ICU) were analyzed. Patients were categorized into two groups: "mortality+" (33 patients) and "mortality-" (327 patients). Factors influencing mortality, including preoperative, intraoperative, and postoperative risk factors, complications, and outcomes, were assessed.
Results: Significant differences were observed between the two groups in factors affecting mortality, including extubation time, ICU stay duration, blood transfusion, surgical reexploration, aortic clamp duration, glomerular filtration rate (GFR), blood urea nitrogen (BUN), creatinine, hemoglobin A1c (HbA1c) levels, and the lowest systolic blood pressure during the first 24 hours in the ICU (p<0.05). The "mortality+" group had longer extubation times and ICU stays, required more blood transfusions, and had higher BUN-creatinine ratios, but lower systolic blood pressures, GFR, and HbA1c levels. Mortality was also higher in patients needing noradrenaline infusions and those who underwent reoperation for bleeding (p<0.05).
Conclusion: By optimizing preoperative renal function, minimizing extubation time, shortening ICU stays, and carefully managing blood transfusions, surgical reexplorations, aortic clamp duration, and HbA1c levels, we believe that the mortality rate can be reduced in elderly patients. Key strategies include shortening aortic clamp times, reducing perioperative blood transfusions, and ensuring effective bleeding control.
{"title":"Determinants of 30-day mortality in elderly patients admitted to a cardiovascular surgery intensive care unit.","authors":"Bedih Balkan, Zahide Özlem Ulubay, Elif Güneysu, Ahmet Said Dündar, Engin Ihsan Turan","doi":"10.14744/tjtes.2024.00569","DOIUrl":"10.14744/tjtes.2024.00569","url":null,"abstract":"<p><strong>Background: </strong>This study aims to identify the factors influencing 30-day morbidity and mortality in patients aged 65 and older undergoing cardiovascular surgery.</p><p><strong>Methods: </strong>Data from 360 patients who underwent cardiac surgery between January 2012 and August 2021 in the Cardiovascular Surgery Intensive Care Unit (CVS ICU) were analyzed. Patients were categorized into two groups: \"mortality+\" (33 patients) and \"mortality-\" (327 patients). Factors influencing mortality, including preoperative, intraoperative, and postoperative risk factors, complications, and outcomes, were assessed.</p><p><strong>Results: </strong>Significant differences were observed between the two groups in factors affecting mortality, including extubation time, ICU stay duration, blood transfusion, surgical reexploration, aortic clamp duration, glomerular filtration rate (GFR), blood urea nitrogen (BUN), creatinine, hemoglobin A1c (HbA1c) levels, and the lowest systolic blood pressure during the first 24 hours in the ICU (p<0.05). The \"mortality+\" group had longer extubation times and ICU stays, required more blood transfusions, and had higher BUN-creatinine ratios, but lower systolic blood pressures, GFR, and HbA1c levels. Mortality was also higher in patients needing noradrenaline infusions and those who underwent reoperation for bleeding (p<0.05).</p><p><strong>Conclusion: </strong>By optimizing preoperative renal function, minimizing extubation time, shortening ICU stays, and carefully managing blood transfusions, surgical reexplorations, aortic clamp duration, and HbA1c levels, we believe that the mortality rate can be reduced in elderly patients. Key strategies include shortening aortic clamp times, reducing perioperative blood transfusions, and ensuring effective bleeding control.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11154066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.14744/tjtes.2024.67520
M. Gedik, Ali İhsan Kilci, Hakan Hakkoymaz, Muhammed Seyithanoğlu, Muhammed Alperen Orakçı, Nuri Mehmet Basan, Arif Aksu, Ömer Faruk Küçük
BACKGROUND The purpose of this study is to determine the significance of markers such as C-reactive protein, procalcitonin, complete blood count parameters, delta neutrophil index, ischemia-modified albumin, presepsin, and oxidative stress indicators, which are associated with inflammation, oxidative stress, and ischemia in the pathology and diagnosis of acute cholecystitis in adults. METHODS Patients diagnosed with acute cholecystitis in the emergency department and healthy individuals in the control group were included in the study. Routine blood count and biochemistry analyses were performed on the participants. Blood serum was used to measure ischemia-modified albumin, presepsin, and oxidative stress indicators. RESULTS White blood cell count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, delta neutrophil index, C-reactive protein, procalcitonin, ischemia-modified albumin, ischemia-modified albumin to albumin ratio, presepsin, and oxidative stress indicators were significantly higher in patients with cholecystitis compared to the control group. Measurements of white blood cell count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and delta neutrophil index can be included as part of the complete blood count. The complete blood count parameters are readily available and do not incur additional costs to the healthcare system. CONCLUSION The authors believe that the neutrophil-to-lymphocyte ratio, delta neutrophil index, ischemia-modified albumin, ischemia-modified albumin to albumin ratio, and presepsin values can be used as new markers in the diagnosis of acute cholecystitis due to their high sensitivity, specificity, and low negative likelihood ratio.
背景本研究的目的是确定 C 反应蛋白、降钙素原、全血细胞计数参数、δ中性粒细胞指数、缺血修饰白蛋白、前蛋白和氧化应激指标等与炎症、氧化应激和缺血相关的指标在成人急性胆囊炎的病理诊断中的意义。对参与者进行常规血细胞计数和生化分析。结果与对照组相比,胆囊炎患者的白细胞计数、中性粒细胞与淋巴细胞比率、血小板与淋巴细胞比率、δ中性粒细胞指数、C反应蛋白、降钙素原、缺血修饰白蛋白、缺血修饰白蛋白与白蛋白比率、降钙素原和氧化应激指标均显著升高。白细胞计数、中性粒细胞与淋巴细胞比率、血小板与淋巴细胞比率和δ中性粒细胞指数的测量可作为全血细胞计数的一部分。作者认为,中性粒细胞与淋巴细胞比值、δ中性粒细胞指数、缺血修饰白蛋白、缺血修饰白蛋白与白蛋白比值和前蛋白值因其高灵敏度、高特异性和低阴性似然比,可作为诊断急性胆囊炎的新标记物。
{"title":"The role of ischemia-modified albumin, presepsin, delta neutrophil index, and inflammatory markers in diagnosing acute cholecystitis.","authors":"M. Gedik, Ali İhsan Kilci, Hakan Hakkoymaz, Muhammed Seyithanoğlu, Muhammed Alperen Orakçı, Nuri Mehmet Basan, Arif Aksu, Ömer Faruk Küçük","doi":"10.14744/tjtes.2024.67520","DOIUrl":"https://doi.org/10.14744/tjtes.2024.67520","url":null,"abstract":"BACKGROUND\u0000The purpose of this study is to determine the significance of markers such as C-reactive protein, procalcitonin, complete blood count parameters, delta neutrophil index, ischemia-modified albumin, presepsin, and oxidative stress indicators, which are associated with inflammation, oxidative stress, and ischemia in the pathology and diagnosis of acute cholecystitis in adults.\u0000\u0000\u0000METHODS\u0000Patients diagnosed with acute cholecystitis in the emergency department and healthy individuals in the control group were included in the study. Routine blood count and biochemistry analyses were performed on the participants. Blood serum was used to measure ischemia-modified albumin, presepsin, and oxidative stress indicators.\u0000\u0000\u0000RESULTS\u0000White blood cell count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, delta neutrophil index, C-reactive protein, procalcitonin, ischemia-modified albumin, ischemia-modified albumin to albumin ratio, presepsin, and oxidative stress indicators were significantly higher in patients with cholecystitis compared to the control group. Measurements of white blood cell count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and delta neutrophil index can be included as part of the complete blood count. The complete blood count parameters are readily available and do not incur additional costs to the healthcare system.\u0000\u0000\u0000CONCLUSION\u0000The authors believe that the neutrophil-to-lymphocyte ratio, delta neutrophil index, ischemia-modified albumin, ischemia-modified albumin to albumin ratio, and presepsin values can be used as new markers in the diagnosis of acute cholecystitis due to their high sensitivity, specificity, and low negative likelihood ratio.","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140757030","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: 10.14744/tjtes.2024.39240
A. U. Seyhan, Rohat Ak, Faruk Şimşek, Senem Ayvacı, Oğuzhan Açıkgöz
BACKGROUND Ankle injuries are a common reason for visits to the emergency department (ED). An effective diagnosis and treatment process is crucial for the swift recovery of patients and for alleviating congestion in EDs. This study aims to evaluate the adequacy and effectiveness of the Ottawa Ankle Rules (OAR) in geriatric patients presenting to the emergency department (ED). METHODS Between February 2022 and November 2022, 160 patients aged 65 and older (118 women, 42 men) who presented to the ED with isolated ankle injuries were included in the study. We calculated the sensitivity, specificity, positive predictive value, and negative predictive value of the OAR. RESULTS The study found fractures in 37.5% of patients. The sensitivity of the OAR was 98.33%, the specificity was 86%, the negative predictive value was 98.85%, and the positive predictive value was 80.82%. CONCLUSION This study demonstrates that the OAR is highly sensitive in the geriatric population but shows some limitations in terms of specificity and positive predictive value. These results support the effectiveness of using the OAR in evaluating ankle injuries in the geriatric population but also highlight the need for cautious application due to the potential for false-positive outcomes.
{"title":"The role of Ottawa ankle rules in geriatric emergency department visits.","authors":"A. U. Seyhan, Rohat Ak, Faruk Şimşek, Senem Ayvacı, Oğuzhan Açıkgöz","doi":"10.14744/tjtes.2024.39240","DOIUrl":"https://doi.org/10.14744/tjtes.2024.39240","url":null,"abstract":"BACKGROUND\u0000Ankle injuries are a common reason for visits to the emergency department (ED). An effective diagnosis and treatment process is crucial for the swift recovery of patients and for alleviating congestion in EDs. This study aims to evaluate the adequacy and effectiveness of the Ottawa Ankle Rules (OAR) in geriatric patients presenting to the emergency department (ED).\u0000\u0000\u0000METHODS\u0000Between February 2022 and November 2022, 160 patients aged 65 and older (118 women, 42 men) who presented to the ED with isolated ankle injuries were included in the study. We calculated the sensitivity, specificity, positive predictive value, and negative predictive value of the OAR.\u0000\u0000\u0000RESULTS\u0000The study found fractures in 37.5% of patients. The sensitivity of the OAR was 98.33%, the specificity was 86%, the negative predictive value was 98.85%, and the positive predictive value was 80.82%.\u0000\u0000\u0000CONCLUSION\u0000This study demonstrates that the OAR is highly sensitive in the geriatric population but shows some limitations in terms of specificity and positive predictive value. These results support the effectiveness of using the OAR in evaluating ankle injuries in the geriatric population but also highlight the need for cautious application due to the potential for false-positive outcomes.","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140768236","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}
BACKGROUND This descriptive analysis examines the victims of the February 6, 2023, earthquakes in Kahramanmaraş and Elbistan, Türkiye. It aims to detail the injury profiles related to neuro-musculoskeletal trauma, assess the rehabilitation needs of patients, and propose a comprehensive rehabilitation approach. METHODS The study included patients injured in the Kahramanmaraş-centered earthquake on February 6, 2023, who were transported to our hospital based on their rehabilitation needs. Data from patients treated at our hospital were recorded retrospectively. This included demographic information, accompanying pathologies, laboratory findings, rehabilitation programs, and treatments received during their hospital stay. Statistical analyses were conducted to examine the data. RESULTS A total of 141 patients with musculoskeletal injuries were admitted due to injuries sustained from the earthquake. The mean age of the participants was 39.76 years, with a slight female predominance (56.7%). The majority of patients sustained injuries while trapped under debris (90.1%), with an average duration of 10 hours under rubble. Fractures were the most common form of injury (53.2%), predominantly affecting the lower extremities. Peripheral nerve injuries were present in 41.1% of patients, and amputations were observed in 30.5%. Complications included compartment syndrome (46.1%), crush syndrome (36.2%), and various infections. Pain was prevalent among patients, with somatic pain being the most reported type. Individualized rehabilitation programs were implemented, incorporating physical therapy, wound care, pain management, and psychosocial support. CONCLUSION This study highlights the critical rehabilitation needs of earthquake survivors and emphasizes the importance of early and comprehensive rehabilitation interventions. Multidisciplinary rehabilitation programs were crucial in addressing medical issues, functional limitations, and psychological challenges faced by the survivors. The findings contribute to a deeper understanding of earthquake-related injuries and underscore the significance of well-coordinated rehabilitation strategies in disaster responses.
{"title":"Clinical properties and rehabilitation needs of earthquake survivors in a subacute rehabilitation setting.","authors":"Emine Esra Bilir, Pınar Borman, Ayşe Merve Ata, Ebru Alemdaroğlu, Hatice Bodur, Burcu Yanık, F. Yurdakul, Bilge Kesikburun, Tuba Güler, Bedriye Başkan, Selami Akkuş, Oznur Uzun, Evren Yaşar","doi":"10.14744/tjtes.2024.27553","DOIUrl":"https://doi.org/10.14744/tjtes.2024.27553","url":null,"abstract":"BACKGROUND\u0000This descriptive analysis examines the victims of the February 6, 2023, earthquakes in Kahramanmaraş and Elbistan, Türkiye. It aims to detail the injury profiles related to neuro-musculoskeletal trauma, assess the rehabilitation needs of patients, and propose a comprehensive rehabilitation approach.\u0000\u0000\u0000METHODS\u0000The study included patients injured in the Kahramanmaraş-centered earthquake on February 6, 2023, who were transported to our hospital based on their rehabilitation needs. Data from patients treated at our hospital were recorded retrospectively. This included demographic information, accompanying pathologies, laboratory findings, rehabilitation programs, and treatments received during their hospital stay. Statistical analyses were conducted to examine the data.\u0000\u0000\u0000RESULTS\u0000A total of 141 patients with musculoskeletal injuries were admitted due to injuries sustained from the earthquake. The mean age of the participants was 39.76 years, with a slight female predominance (56.7%). The majority of patients sustained injuries while trapped under debris (90.1%), with an average duration of 10 hours under rubble. Fractures were the most common form of injury (53.2%), predominantly affecting the lower extremities. Peripheral nerve injuries were present in 41.1% of patients, and amputations were observed in 30.5%. Complications included compartment syndrome (46.1%), crush syndrome (36.2%), and various infections. Pain was prevalent among patients, with somatic pain being the most reported type. Individualized rehabilitation programs were implemented, incorporating physical therapy, wound care, pain management, and psychosocial support.\u0000\u0000\u0000CONCLUSION\u0000This study highlights the critical rehabilitation needs of earthquake survivors and emphasizes the importance of early and comprehensive rehabilitation interventions. Multidisciplinary rehabilitation programs were crucial in addressing medical issues, functional limitations, and psychological challenges faced by the survivors. The findings contribute to a deeper understanding of earthquake-related injuries and underscore the significance of well-coordinated rehabilitation strategies in disaster responses.","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140783989","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}
BACKGROUND The continuous advancement in medical and surgical techniques has led to a rise in the frequency of abdominal operations, subsequently increasing the incidence of intra-abdominal adhesions. Over 90% of laparotomies result in postoperative intra-abdominal adhesions. This study investigates the effect of a 5% boric acid solution on the development of intra-abdominal adhesions in rats, using an adhesion model. METHODS This study was conducted with two groups: a control group, in which the adhesion model was applied without any treatment, and a boric acid group, which was treated with a 5% boric acid solution. Each group comprised 16 rats. On the 14th postoperative day, the rats were sacrificed, re-explored, and the developed adhesions were evaluated both macroscopically and microscopically. The data from macroscopic and microscopic scoring were analyzed using the Mann-Whitney U test in the IBM Statistical Package for the Social Sciences (SPSS) Statistics 24 program. A p-value of less than 0.05 was considered statistically significant. This research was supported by the Manisa Celal Bayar University Scientific Research Projects Commission. RESULTS A statistically significant difference was observed between the boric acid-treated group and the control group, with the boric acid group showing a significant decrease in adhesion development both macroscopically and microscopically (p<0.05). CONCLUSION In the future, boron could play a significant role in reducing and preventing intra-abdominal adhesions after surgery. This investigation could pave the way for further research into the mechanism by which boric acid prevents the development of intra-abdominal adhesions. Moreover, it is imperative to explore the potential side effects of intra-abdominal boron application at the optimum concentration of the solution.
{"title":"Effect of intra-abdominal boric acid in the experimental adhesion model.","authors":"Rıdvan Barkın Kabalar, Semra Tutcu Şahin, Semin Ayhan","doi":"10.14744/tjtes.2024.77767","DOIUrl":"https://doi.org/10.14744/tjtes.2024.77767","url":null,"abstract":"BACKGROUND\u0000The continuous advancement in medical and surgical techniques has led to a rise in the frequency of abdominal operations, subsequently increasing the incidence of intra-abdominal adhesions. Over 90% of laparotomies result in postoperative intra-abdominal adhesions. This study investigates the effect of a 5% boric acid solution on the development of intra-abdominal adhesions in rats, using an adhesion model.\u0000\u0000\u0000METHODS\u0000This study was conducted with two groups: a control group, in which the adhesion model was applied without any treatment, and a boric acid group, which was treated with a 5% boric acid solution. Each group comprised 16 rats. On the 14th postoperative day, the rats were sacrificed, re-explored, and the developed adhesions were evaluated both macroscopically and microscopically. The data from macroscopic and microscopic scoring were analyzed using the Mann-Whitney U test in the IBM Statistical Package for the Social Sciences (SPSS) Statistics 24 program. A p-value of less than 0.05 was considered statistically significant. This research was supported by the Manisa Celal Bayar University Scientific Research Projects Commission.\u0000\u0000\u0000RESULTS\u0000A statistically significant difference was observed between the boric acid-treated group and the control group, with the boric acid group showing a significant decrease in adhesion development both macroscopically and microscopically (p<0.05).\u0000\u0000\u0000CONCLUSION\u0000In the future, boron could play a significant role in reducing and preventing intra-abdominal adhesions after surgery. This investigation could pave the way for further research into the mechanism by which boric acid prevents the development of intra-abdominal adhesions. Moreover, it is imperative to explore the potential side effects of intra-abdominal boron application at the optimum concentration of the solution.","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140768407","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: 10.14744/tjtes.2024.20813
Cengiz Ceylan
Following extended colon resections, it may not always be possible to perform colorectal anastomosis. The Deloyers procedure, which involves the transposition of the right colon, has been identified as a viable solution. This report aims to discuss the circumstances under which the Deloyers procedure was performed, as well as to evaluate the early and late postoperative outcomes, by reviewing cases conducted between 2010 and 2023. In a 22-year-old female patient who suffered major organ and tissue loss (with injuries to the sigmoid colon, descending colon, transverse colon, and mesentery) due to a firearm injury, the Deloyers procedure was applied during restorative surgery following initial damage control surgery. The procedure involved mobilizing the cecum and right colon, performing a cranio-caudal rotation over the ileocolic artery pedicle, followed by an appendectomy, and creating a colorectal anastomosis using circular staplers. There were no complications during the postoperative follow-ups. By the 14th postoperative day, the patient was discharged and experienced bowel movements four times a day, managed with 2.5 mg of diphenoxylate hydrochloride and 0.025 mg of atropine sulfate. At the 6-month follow-up, the frequency of bowel movements had decreased to twice daily without the need for medical treatment. Given the functional outcomes in patients after extended left colectomies, the Deloyers procedure, with its low associated morbidity, stands out as a viable option.
{"title":"Firearm injury and the Deloyers procedure: case report and literature review.","authors":"Cengiz Ceylan","doi":"10.14744/tjtes.2024.20813","DOIUrl":"https://doi.org/10.14744/tjtes.2024.20813","url":null,"abstract":"Following extended colon resections, it may not always be possible to perform colorectal anastomosis. The Deloyers procedure, which involves the transposition of the right colon, has been identified as a viable solution. This report aims to discuss the circumstances under which the Deloyers procedure was performed, as well as to evaluate the early and late postoperative outcomes, by reviewing cases conducted between 2010 and 2023. In a 22-year-old female patient who suffered major organ and tissue loss (with injuries to the sigmoid colon, descending colon, transverse colon, and mesentery) due to a firearm injury, the Deloyers procedure was applied during restorative surgery following initial damage control surgery. The procedure involved mobilizing the cecum and right colon, performing a cranio-caudal rotation over the ileocolic artery pedicle, followed by an appendectomy, and creating a colorectal anastomosis using circular staplers. There were no complications during the postoperative follow-ups. By the 14th postoperative day, the patient was discharged and experienced bowel movements four times a day, managed with 2.5 mg of diphenoxylate hydrochloride and 0.025 mg of atropine sulfate. At the 6-month follow-up, the frequency of bowel movements had decreased to twice daily without the need for medical treatment. Given the functional outcomes in patients after extended left colectomies, the Deloyers procedure, with its low associated morbidity, stands out as a viable option.","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140778072","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: 10.14744/tjtes.2024.47835
M. Mısırlıoğlu, Mehmet Alakaya, A. Arslankoylu, G. Bozlu, Fatma Durak, Ali Delibaş, Serra Surmeli Doven, Ozlem Tezol, Edanur Yeşil, Feryal Karahan, İsa Kıllı, Mehtap Akça
BACKGROUND In our earthquake-prone country, it is crucial to gather data from regional hospitals following earthquakes. This information is essential for preparing for future disasters and enhancing healthcare services for those affected by earthquakes. This study aimed to evaluate the Pediatric Trauma Score (PTS) and the Shock Index, Pediatric Age-Adjusted (SIPA), in children affected by earthquakes, to provide clinicians with insights into the severity of trauma and hemodynamic stability. METHODS The study included patients admitted to our hospital's pediatric emergency service within the three weeks following the earthquake. We evaluated their age, sex, admission vital signs, mechanical ventilation requirements, development of crush syndrome, length of hospital stay, PTS, and SIPA. RESULTS Our study included 176 children (89 females and 87 males) with trauma. Fifty-eight (32.95%) children had crush syndrome, and 87 (49.43%) were hospitalized. The median PTS was 10 (ranging from -3 to 12), and the median SIPA was 1.00 (ranging from 0.57 to 2.10). We observed a negative correlation between the time spent under debris and PTS (r=-0.228, p=0.002) and a positive correlation with the SIPA score (r=0.268, p<0.001). The time spent under debris (p<0.001) and SIPA score (p<0.001) were significantly higher in hospitalized children. PTS was significantly lower in hospitalized children than in others. A PTS cutoff point of 7.5, and a SIPA cutoff point of 1.05, predicted hospitalization in all children. Time spent under debris and SIPA were significantly higher in children with crush syndrome than in others (p<0.001). PTS at a cutoff point of 8.5 and SIPA at a cutoff point of 1.05 predicted crush syndrome in all children. CONCLUSION PTS and SIPA are important practical scoring systems that can be used to predict the severity of trauma, hospitalization, crush syndrome, and the clinical course in pediatric patients admitted to the hospital due to earthquake trauma.
{"title":"Evaluation of pediatric trauma score and pediatric age-adjusted shock index in pediatric patients admitted to the hospital after an earthquake.","authors":"M. Mısırlıoğlu, Mehmet Alakaya, A. Arslankoylu, G. Bozlu, Fatma Durak, Ali Delibaş, Serra Surmeli Doven, Ozlem Tezol, Edanur Yeşil, Feryal Karahan, İsa Kıllı, Mehtap Akça","doi":"10.14744/tjtes.2024.47835","DOIUrl":"https://doi.org/10.14744/tjtes.2024.47835","url":null,"abstract":"BACKGROUND\u0000In our earthquake-prone country, it is crucial to gather data from regional hospitals following earthquakes. This information is essential for preparing for future disasters and enhancing healthcare services for those affected by earthquakes. This study aimed to evaluate the Pediatric Trauma Score (PTS) and the Shock Index, Pediatric Age-Adjusted (SIPA), in children affected by earthquakes, to provide clinicians with insights into the severity of trauma and hemodynamic stability.\u0000\u0000\u0000METHODS\u0000The study included patients admitted to our hospital's pediatric emergency service within the three weeks following the earthquake. We evaluated their age, sex, admission vital signs, mechanical ventilation requirements, development of crush syndrome, length of hospital stay, PTS, and SIPA.\u0000\u0000\u0000RESULTS\u0000Our study included 176 children (89 females and 87 males) with trauma. Fifty-eight (32.95%) children had crush syndrome, and 87 (49.43%) were hospitalized. The median PTS was 10 (ranging from -3 to 12), and the median SIPA was 1.00 (ranging from 0.57 to 2.10). We observed a negative correlation between the time spent under debris and PTS (r=-0.228, p=0.002) and a positive correlation with the SIPA score (r=0.268, p<0.001). The time spent under debris (p<0.001) and SIPA score (p<0.001) were significantly higher in hospitalized children. PTS was significantly lower in hospitalized children than in others. A PTS cutoff point of 7.5, and a SIPA cutoff point of 1.05, predicted hospitalization in all children. Time spent under debris and SIPA were significantly higher in children with crush syndrome than in others (p<0.001). PTS at a cutoff point of 8.5 and SIPA at a cutoff point of 1.05 predicted crush syndrome in all children.\u0000\u0000\u0000CONCLUSION\u0000PTS and SIPA are important practical scoring systems that can be used to predict the severity of trauma, hospitalization, crush syndrome, and the clinical course in pediatric patients admitted to the hospital due to earthquake trauma.","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140777995","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: 10.14744/tjtes.2024.98200
M. Celikmen, Mustafa Cicek, Melih Imamoğlu, Verda Tunalıgil
BACKGROUND Firing guns into the air during celebrations is a tradition that poses significant risks to public safety. These falling bullets, often referred to as tired bullets, can attain high velocities during their descent and have the potential to cause serious injury or death to people and animals, or significant damage to property upon impact. METHODS This study aimed to retrospectively detect and analyze incidents of celebratory gunfire-related injuries (CGRI) that were admitted to three different hospitals in two cities in Turkey over a 10-year period from 2014 to 2023. RESULTS Data collected from Trabzon Kanuni Training and Research Hospital, Karadeniz Technical University Faculty of Medicine Farabi Hospital, and Yeditepe University Kozyatağı Hospital revealed 48 cases of injuries attributed to celebratory gunfire. Of these cases, 64.6% involved male victims. Children aged 0-17 years were the most affected demographic, with the head, neck, and face being the most frequently injured areas. The majority of incidents occurred in rural areas. Eight cases (16.7%) resulted in fatalities. The reasons for gunfire in 43.8% of the cases could not be determined. CONCLUSION Sociologically, gun ownership is often associated with prestige and can trigger the use of firearms in celebrations, such as weddings, in some societies. However, this tradition can result in tragic consequences worldwide. Stricter regulations and legal frameworks are necessary to prevent the use of unlicensed weapons. Collaborative efforts are crucial for effectively addressing the societal normalization of celebratory gunfire. Future prospective studies can comprehensively evaluate the incidence of CGRI and identify effective preventive strategies to safeguard public health.
{"title":"A dangerous tradition: retrospective analysis of celebratory gunfire-related injuries in three tertiary hospitals.","authors":"M. Celikmen, Mustafa Cicek, Melih Imamoğlu, Verda Tunalıgil","doi":"10.14744/tjtes.2024.98200","DOIUrl":"https://doi.org/10.14744/tjtes.2024.98200","url":null,"abstract":"BACKGROUND\u0000Firing guns into the air during celebrations is a tradition that poses significant risks to public safety. These falling bullets, often referred to as tired bullets, can attain high velocities during their descent and have the potential to cause serious injury or death to people and animals, or significant damage to property upon impact.\u0000\u0000\u0000METHODS\u0000This study aimed to retrospectively detect and analyze incidents of celebratory gunfire-related injuries (CGRI) that were admitted to three different hospitals in two cities in Turkey over a 10-year period from 2014 to 2023.\u0000\u0000\u0000RESULTS\u0000Data collected from Trabzon Kanuni Training and Research Hospital, Karadeniz Technical University Faculty of Medicine Farabi Hospital, and Yeditepe University Kozyatağı Hospital revealed 48 cases of injuries attributed to celebratory gunfire. Of these cases, 64.6% involved male victims. Children aged 0-17 years were the most affected demographic, with the head, neck, and face being the most frequently injured areas. The majority of incidents occurred in rural areas. Eight cases (16.7%) resulted in fatalities. The reasons for gunfire in 43.8% of the cases could not be determined.\u0000\u0000\u0000CONCLUSION\u0000Sociologically, gun ownership is often associated with prestige and can trigger the use of firearms in celebrations, such as weddings, in some societies. However, this tradition can result in tragic consequences worldwide. Stricter regulations and legal frameworks are necessary to prevent the use of unlicensed weapons. Collaborative efforts are crucial for effectively addressing the societal normalization of celebratory gunfire. Future prospective studies can comprehensively evaluate the incidence of CGRI and identify effective preventive strategies to safeguard public health.","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140788056","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}