Surgery Commons^™

Early Versus Late Intramedullary Nailing For Traumatic Femur Fracture Management: Meta-Analysis, Ayman El-Menyar, Mohammed Muneer, David Samson, Hassan Al-Thani, Ahmad Alobaidi, Paul Mussleman, Rifat Latifi

NYMC Faculty Publications

INTRODUCTION: There is no consensus yet on the impact of timing of femur fracture (FF) internal fixation on the patient outcomes. This meta-analysis was conducted to evaluate the contemporary data in patients with traumatic FF undergoing intramedullary nail fixation (IMN). METHODS: English language literature was searched with publication limits set from 1994 to 2016 using PubMed, Scopus, MEDLINE (OVID), EMBASE (OVID), Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL). Studies included randomized controlled trials (RCTs), prospective observational or retrospective cohort studies, and case-control studies comparing early versus late femoral shaft fractures IMN fixation. Variable times were used …

Wses Worldwide Emergency General Surgery Formation And Evaluation Project, Federico Coccolini, Yoram Kluger, Luca Ansaloni, Ernest E. Moore, Raul Coimbra, Gustavo P. Fraga, Andrew Kirkpatrick, Andrew Peitzman, Ron Maier, Gianluca Baiocchi, Vanni Agnoletti, Emiliano Gamberini, Ari Leppaniemi, Rao Ivatury, Michael Sugrue, Massimo Sartelli, Salomone Di Saverio, Walt Biffl, Fausto Catena

Surgery Publications

Optimal management of emergency surgical patients represents one of the major health challenges worldwide. Emergency general surgery (EGS) was identified as multidisciplinary surgery performed for traumatic and nontraumatic acute conditions during the same admission in the hospital. EGS represents the easiest viable way to provide affordable and high-quality level of care to emergency surgical and trauma patients. It may result from the association of different physicians with other specialties in a cooperative model. The World Society of Emergency Surgery (WSES) has been working on the EGS organization and implementation since its foundation believing in the need of common benchmarks for …

Circulation First – The Time Has Come To Question The Sequencing Of Care In The Abcs Of Trauma; An American Association For The Surgery Of Trauma Multicenter Trial, Paula Ferrada, Rachael A. Callcut, David J. Skarupa, Therese M. Duane, Alberto Garcia, Kenji Inaba, Desmond Khor, Vincent Anto, Jason Sperry, David Turay, Rachel M. Nygaard, Martin A. Schreiber, Toby Enniss, Michelle Mcnutt, Herb Phelan, Kira Smith, Forrest O. Moore, Irene Tabas, Joseph Dubose, Aast Multi-Institutional Trials Committee

Surgery Publications

Background

The traditional sequence of trauma care: Airway, Breathing, Circulation (ABC) has been practiced for many years. It became the standard of care despite the lack of scientific evidence. We hypothesized that patients in hypovolemic shock would have comparable outcomes with initiation of bleeding treatment (transfusion) prior to intubation (CAB), compared to those patients treated with the traditional ABC sequence.

Methods

This study was sponsored by the American Association for the Surgery of Trauma multicenter trials committee. We performed a retrospective analysis of all patients that presented to trauma centers with presumptive hypovolemic shock indicated by pre-hospital or emergency department …

Trauma Team Activation For Geriatric Trauma At A Level Ii Trauma Center: Are The Elderly Under-Triaged?, Grant S. Buchanan, Daniel Scott Kahn, Harry Burke, Brian Czarkowski, Richard Boe, Milad Modarresi, Franklin D. Shuler

Marshall Journal of Medicine

Abstract

Geriatric patients often sustain life-threatening injuries from minor trauma. A growing body of research suggests that these patients are often under-triaged in the emergency setting.The purpose of this research was to evaluate whether or not geriatric trauma patients are under-triaged at a community based level II trauma center.

1434 trauma patients over the age of 65 presenting from 2010-2015 were retrospectively reviewed from the Cabell Huntington Hospital trauma registry and analyzed for age, gender, arrival type, ED response, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), injury cause, ICD-9 diagnosis codes, and mortality. Under-triage and over-triage rates were determined …

Anterior Cervical Infection: Presentation And Incidence Of An Uncommon Postoperative Complication., George M. Ghobrial, James S. Harrop, Rick C. Sasso, Chadi A. Tannoury, Tony Tannoury, Zachary A. Smith, Wellington K. Hsu, Paul M. Arnold, Michael G. Fehlings, Thomas E. Mroz, Anthony F. De Giacomo, Bruce C. Jobse, Ra'kerry K. Rahman, Sara E. Thompson, K Daniel Riew

Department of Neurosurgery Faculty Papers

STUDY DESIGN: Retrospective multi-institutional case series.

OBJECTIVE: The anterior cervical discectomy and fusion (ACDF) affords the surgeon the flexibility to treat a variety of cervical pathologies, with the majority being for degenerative and traumatic indications. Limited data in the literature describe the presentation and true incidence of postoperative surgical site infections.

METHODS: A retrospective multicenter case series study was conducted involving 21 high-volume surgical centers from the AOSpine North America Clinical Research Network, selected for their excellence in spine care and clinical research infrastructure and experience. Medical records for 17 625 patients who received cervical spine surgery (levels from C2 …

Advocacy Efforts In Trauma And Acute Care Surgery: Learning To Walk, Lewis J. Kaplan, Erik Barquist, Donald Jenkins, Orlando C. Kirton

Abington Jefferson Health Papers

No abstract provided.

Pelvic Trauma: Wses Classification And Guidelines, Federico Coccolini, Philip F. Stahel, Giulia Montori, Walter Biffl, Tal M. Horer, Fausto Catena, Yoram Kluger, Ernest E. Moore, Andrew B. Peitzman, Rao Ivatury, Raul Coimbra, Gustavo Pereira Fraga, Bruno Pereira, Sandro Rizoli, Andrew Kirkpatrick, Ari Leppaniemi, Roberto Manfredi, Stefano Magnone, Osvaldo Chiara, Leonardo Solaini, Marco Ceresoli, Niccolò Allievi, Catherine Arvieux, George Velmahos, Zsolt Balogh, Noel Naidoo, Dieter Weber, Fikri Abu-Zidan, Massimo Sartelli, Luca Ansaloni

Surgery Publications

Complex pelvic injuries are among the most dangerous and deadly trauma related lesions. Different classification systems exist, some are based on the mechanism of injury, some on anatomic patterns and some are focusing on the resulting instability requiring operative fixation. The optimal treatment strategy, however, should keep into consideration the hemodynamic status, the anatomic impairment of pelvic ring function and the associated injuries. The management of pelvic trauma patients aims definitively to restore the homeostasis and the normal physiopathology associated to the mechanical stability of the pelvic ring. Thus the management of pelvic trauma must be multidisciplinary and should be …

Splenic Trauma: Wses Classification And Guidelines For Adult And Pediatric Patients, Federico Coccolini, Giulia Montori, Fausto Catena, Yoram Kluger, Walter Biffl, Ernest E. Moore, Viktor Reva, Camilla Bing, Miklosh Bala, Paola Fugazzola, Hany Bahouth, Ingo Marzi, George Velmahos, Rao Ivatury, Kjetil Soreide, Tal Horer, Richard Ten Broek, Bruno M. Pereira, Gustavo P. Fraga, Kenji Inaba, Joseph Kashuk, Neil Parry, Peter T. Masiakos, Konstantinos S. Mylonas, Andrew Kirkpatrick, Fikri Abu-Zidan, Carlos Augusto Gomes, Simone Vasilij Benatti, Noel Naidoo, Francesco Salvetti, Stefano Maccatrozzo, Vanni Agnoletti, Emiliano Gamberini, Leonardo Solaini, Antonio Costanzo, Andrea Celotti, Matteo Tomasoni, Vladimir Khokha, Catherine Arvieux, Lena Napolitano, Lauri Handolin, Michele Pisano Pisano, Stefano Magnone, David A. Spain, Marc De Moya, Kimberly A. Davis, Nicola De Angelis, Ari Leppaniemi, Paula Ferrada, Rifat Latifi, David Costa Navarro, Yashuiro Otomo, Raul Coimbra, Ronald V. Maier, Frederick Moore, Sandro Rizoli, Boris Sakakushev, Joseph M. Galante, Osvaldo Chiara, Stefania Cimbanassi, Alain Chichom Mefire, Dieter Weber, Marco Ceresoli, Andrew B. Peitzman, Liban Wehlie, Massimo Sartelli, Salomone Di Saverio, Luca Ansaloni

Surgery Publications

Spleen injuries are among the most frequent trauma-related injuries. At present, they are classified according to the anatomy of the injury. The optimal treatment strategy, however, should keep into consideration the hemodynamic status, the anatomic derangement, and the associated injuries. The management of splenic trauma patients aims to restore the homeostasis and the normal physiopathology especially considering the modern tools for bleeding management. Thus, the management of splenic trauma should be ultimately multidisciplinary and based on the physiology of the patient, the anatomy of the injury, and the associated lesions. Lastly, as the management of adults and children must be …

The Effects Of Tranexamic Acid On Mortality Rate In Trauma Patients Compared To Trauma Patients With No Tranexamic Acid Treatment, Bradley Earl Tolar

Doctoral Projects

Traumatic injury is the leading cause of death for many age groups. Traumatic accidents caused over 130,000 deaths in the United States in 2014. This DNP project studied the effects of Tranexamic acid on mortality rate in trauma patients. After the completion of a needs assessment at a local level II trauma center, a literature review was performed. The literature showed a decrease in mortality rate when patients were administered Tranexamic acid within 3 hours of injury with statistically significant statistics. Also, the data from the literature showed no correlation between vascular occlusive events and Tranexamic acid use in trauma …

Return To Play After Cervical Spine Injuries: A Consensus Of Opinion., John C. France, Michael Karsy, James S. Harrop, Andrew T. Dailey

Department of Neurosurgery Faculty Papers

Study Design Survey. Objective Sports-related spinal cord injury (SCI) represents a growing proportion of total SCIs but lacks evidence or guidelines to guide clinical decision-making on return to play (RTP). Our objective is to offer the treating physician a consensus analysis of expert opinion regarding RTP that can be incorporated with the unique factors of a case for clinical decision-making. Methods Ten common clinical scenarios involving neurapraxia and stenosis, atlantoaxial injury, subaxial injury, and general cervical spine injury were presented to 25 spine surgeons from level 1 trauma centers for whom spine trauma is a significant component of their practice. …

Traumatic Posterior Tibial Pseudoaneursym: A Rare Late Complication Repaired Conventionally, Farzad Amiri, Md, Zachary Sanford, Constantinous Constantinou, Md

Marshall Journal of Medicine

Posterior tibial artery pseudoaneurysms are extremely rare. They commonly present as a late complication of trauma or iatrogenic injury. Diagnosis can be elusive. Treatment has been described in the context of open primary repair, endovascular stenting, and coil embolization. There has been increasing interest in the use of endovascular treatment options for this type of injury. If left untreated, pseudoaneurysms can rupture, partially thrombose, expand and cause adjacent local compression and compartment syndrome. The following case presented is of a young gentleman with a posterior tibial pseudoaneurysm incidentally discovered after stepping on glass and the management of his posterior tibial …

Modern Evaluation Of Abdominal Trauma, Errington C. Thompson, Md, Chadwick J. Knight, Md

Marshall Journal of Medicine

Abdominal trauma can be mysterious to some physicians. If patients are evaluated for being stable or unstable, then abdominal trauma can be easily managed. Using a combination of physical examination, ultrasound and CT scans, patients can be quickly and efficiently evaluated.

Paucity Of Trauma Literature From A Highly Burdened Developing Country, Rizwan Sultan, Hasnain Zafar

Department of Surgery Docs

Abstract Introduction: Trauma is the leading cause of death among a younger population not only in USA but in Pakistan as well. The high prevalence of disease should result in a larger amount of data and a larger number of publications resulting in the ability to explore improvements in the field. This study aimed to review the trauma literature generated from Pakistan. Methods: Journals indexed with PubMed from January 2010 to December 2014 were searched using the search term ‘‘Trauma AND Pakistan’’ filtering for relevant dates and human reports only. The abstracts and articles were reviewed by the authors to …

Iroa: The International Register Of Open Abdomen., Frederico Coccolini, Fausto Catena, Giulia Montori, Marco Ceresoli, Roberto Manfredi, Gabriela Elisa Nita, Ernest E. Moore, Walter Biffl, Rao Ivatury, James Whelan, Gustavo Fraga, Ari Leppaniemi, Massimo Sartelli, Salomone Di Saverio, Luca Ansaloni

Surgery Publications

Actually the most common indications for Open Abdomen (OA) are trauma, abdominal sepsis, severe acute pancreatitis and more in general all those situations in which an intra-abdominal hypertension condition is present, in order to prevent the development of an abdominal compartment syndrome. The mortality and morbidity rate in patients undergone to OA procedures is still high. At present many studies have been published about the OA management and the progresses in survival rate of critically ill trauma and septic surgical patients. However several issues are still unclear and need more extensive studies. The definitions of indications, applications and methods to …

Emergency Reversal Of Antiplatelet Agents In Patients Presenting With An Intracranial Hemorrhage: A Clinical Review, Peter G. Campbell, Md, Anish Sen, Bs, Sanjay Yadla, Md, Pascal Jabbour, Md, Jack Jallo, Md, Phd

Department of Neurosurgery Faculty Papers

Abstract

Objective: Prehospital use of antiplatelet agents has been associated with an increased risk for ICH as well as a secondary increase in ICH volume after the initial hemorrhage. Strategies to reestablish platelet aggregation are used in clinical practice, but without any established guidelines or recommendations. This article serves to evaluate the literature regarding “reversal” of antiplatelet agents in neurosurgical populations.

Methods: PUBMED and MEDLINE databases were searched for publications from 1966 to 2009 relating to intracranial hemorrhage and antiplatelet agents. The reference sections of recent articles, guidelines and reviews were reviewed and pertinent articles identified. Studies were classified by …

The Trauma Centre: What It Should Mean, Rashid Jooma, Sabeena Jalal Khan, Junaid Razzak

Section of Neurosurgery

No abstract provided.

Towards A Cure For Traumatic Paraplegia - Is There Cause For Hope?, Rashid Jooma

Section of Neurosurgery

In the past decade, great strides have been made in the field of CNS tissue repair and expectations have been raised that a cure of spinal paralysis is at hand. The two broad categories of investigational approaches to spinal regeneration are: (1) Enhancing the Regenerative Milieu of the Cord and (2) Cellular and Tissue Transplantation. Amongst the latter approaches, the early use of foetal cord tissue has given way to the more sophisticated studies on stem cell therapy and the implants of olfactory ensheating cells. These have engendered considerable public interest and are being offered as commercially available therapies in …

Dural Metastases Presenting As An Extradural Hematoma: A Rare Presentation, Muhammad Shahzad Shamim, Muhammad Ehsan Bari, S. Ather Enam

Department of Surgery Docs

Abstract

We report a case of an elderly man who presented with hemiparesis and plain CT scan findings highly suggestive of an extradural hematoma as the underlying cause. This patient was later found to have dural metastases secondary to bronchogenic carcinoma. Dural metastases are rare, usually presenting as dural mass, but may also present as chronic subdural or extradural hematoma on non contrast CT scan, leading to an erroneous diagnosis in the unsuspecting.

Peer Review Audit Of Trauma Deaths In A Developing Country, Aa Jat, Mr Khan, Hasnain Zafar, Aj Raja, Q Hoda, R Rehmani, Rh Lakdawala, S. Bashir

Section of General Surgery

OBJECTIVES: Peer review of trauma deaths can be used to evaluate the efficacy of trauma systems. The objective of this study was to estimate teh proportion of preventable trauma deaths and the factors contributing to poor outcome using peer review in a tertiary care hospital in a developing country.
METHODS: All trauma deaths during a 2-year period (1 January 1998 to 30 December 1998) were identified and registered in a computerized trauma registry, and the probability of survival was calculated for all patients. Summary data, including registry information and details of prehospital, emergency room, and definitive care, were provided to …

Trauma Outcome: Review Of Results In Urban Hospital In Southern Pakistan, Hasnain Zafar, Fuad Abid, Asad Jamil Raja, Mushtaq Ahmed, Faheem Nanajani, Yousuf Kamal Mirza

Section of General Surgery

No abstract provided.