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Full-Text Articles in Medicine and Health Sciences
Temporary Intravascular Shunts After Civilian Arterial Injury: A Prospective Multicenter Eastern Association For The Surgery Of Trauma Study, Lily Tung, Jennifer Leonard, Ryan A. Lawless, Alexis Cralley, Richard Betzold, Jason D. Pasley, Kenji Inaba, Jennie S. Kim, Dennis Y. Kim, Kwang Kim, Bradley M. Dennis, Michael C. Smith, Margaret Moore, Christina Tran, Joshua P. Hazelton, Atlee Melillo, Tejal S. Brahmbhatt, Stephanie Talutis, Noelle N. Saillant, Jae Moo Lee, Mark J. Seamon
Temporary Intravascular Shunts After Civilian Arterial Injury: A Prospective Multicenter Eastern Association For The Surgery Of Trauma Study, Lily Tung, Jennifer Leonard, Ryan A. Lawless, Alexis Cralley, Richard Betzold, Jason D. Pasley, Kenji Inaba, Jennie S. Kim, Dennis Y. Kim, Kwang Kim, Bradley M. Dennis, Michael C. Smith, Margaret Moore, Christina Tran, Joshua P. Hazelton, Atlee Melillo, Tejal S. Brahmbhatt, Stephanie Talutis, Noelle N. Saillant, Jae Moo Lee, Mark J. Seamon
School of Medicine Faculty Publications
Introduction: We sought to determine the impact of the indication for shunt placement on shunt-related outcomes after major arterial injuries. We hypothesized that a shunt placed for damage control indications would be associated with an increase in shunt-related complications including shunt dislodgement, thrombosis, or distal ischemia. Patients & methods: A prospective, multicenter study (eleven level one US trauma centers) of all adult trauma patients undergoing temporary intravascular shunts (TIVS) after arterial injury was undertaken (January 2017-May 2019). Exclusion criteria included age <15years, shunt placement distal to popliteal/brachial arteries, isolated venous shunts, and death before shunt removal. Clinical variables were compared by indication and shunt-related complications. The primary endpoint was TIVS complications (thrombosis, migration, distal ischemia). Results: The 66 patients who underwent TIVS were primarily young (30years [IQR 22-36]) men (85%), severely injured (ISS 17 [10-25]) by penetrating mechanisms (59%), and had their shunts placed for damage control (41%). After a median SDT of 198min [89-622], 9% experienced shunt-related complications. Compared by shunt placement indication (damage control shunts [n=27] compared to non-damage control shunts [n=39]), there were no differences in gender, mechanism, extremity AIS, MESS score, fractures, or surgeon specialty between the two groups (all p>0.05). Patients with shunts placed for damage control indications had more severe injuries (ISS 23.5 compared to 13; SBP …
History Of The Innovation Of Damage Control For Management Of Trauma Patients: 1902-2016, Derek J. Roberts, Chad G. Ball, David V. Feliciano, Ernest E. Moore, Rao R. Ivatury, Charles E. Lucas, Timothy C. Fabian, David A. Zygun, Andrew W. Kirkpatrick, Henry T. Stelfox
History Of The Innovation Of Damage Control For Management Of Trauma Patients: 1902-2016, Derek J. Roberts, Chad G. Ball, David V. Feliciano, Ernest E. Moore, Rao R. Ivatury, Charles E. Lucas, Timothy C. Fabian, David A. Zygun, Andrew W. Kirkpatrick, Henry T. Stelfox
Surgery Publications
Objective: To review the history of the innovation of damage control (DC) for management of trauma patients.
Background: DC is an important development in trauma care that provides a valuable case study in surgical innovation.
Methods: We searched bibliographic databases (1950-2015), conference abstracts (2009-2013), Web sites, textbooks, and bibliographies for articles relating to trauma DC. The innovation of DC was then classified according to the Innovation, Development, Exploration, Assessment, and Long-term study model of surgical innovation.
Results: The "innovation'' of DC originated from the use of therapeutic liver packing, a practice that had previously been abandoned after World War II …
Principles Of Combat Surgical Care In A Staged Evacuation System, Vivian C. Mcalister, Rob Stiegelmar, Brian Church, Ray Kao
Principles Of Combat Surgical Care In A Staged Evacuation System, Vivian C. Mcalister, Rob Stiegelmar, Brian Church, Ray Kao
Vivian C. McAlister
Background: The NATO hospital classification of hospitals describes an orderly transfer of patients with severe injuries through a series of increasingly sophisticated hospitals as they are brought from the point of injury to their home hospital. Forward hospital surgery is restricted to damage control and resuscitation while definitive surgery is performed at home by the destination surgical team. In reality many patients enter the hospital chain higher up and some receive definitive surgery as they proceed through the chain of evacuation. The purpose of this paper is to determine if clear doctrine exists to guide the performance of surgery on …