Wounds and Injuries Commons^™

Assessing The Impact Dynamics Of Less Lethal Ammunition, Steven Bermejo

Student Theses

Less-lethal ammunition is widely used by law enforcement as an alternative to lethal force during crowd control, on-street confrontations, and other situations requiring force. Although these projectiles are intended to reduce risk of fatal injury, serious injuries and fatalities have been reported, highlighting the need to better understand the factors that influence their impact behavior. This study evaluated the impact dynamics of four types of 12-gauge less-lethal ammunition, including rubber buckshot, single rubber ball, double rubber ball, and Byrna kinetic projectile, using kinetic energy calculations derived from projectile mass and velocity measurements. In addition, Attenuated Total Reflectance Fourier Transform Infrared …

Standardized Infection Prevention Protocol To Reduce Surgical Site Infections In Pediatric Neurosurgery, Pisey Kareth

Doctor of Nursing Practice (DNP) Scholarly Project

Problem: Surgical site infections (SSIs) are a significant concern in the pediatric neurosurgical patient population and are associated with increased morbidity, longer hospital stays, and increased medical expenses. The absence of a standardized preoperative infection prevention process led to variability in perioperative care practices and infections at the practicum site.

Aim of the Project: The aim of the project was to reduce the incidence of SSIs among pediatric patients undergoing neurosurgical procedures who were initially evaluated in an ambulatory setting.

Review of the Evidence: Evidence supports the implementation of bundled infection prevention strategies as a more effective approach to reducing …

Mathematical Modeling Of The Combined Effects Of Thermal Burn And Local Irradiation, Quintessa Hay, Rachel Jennings, Amy Creel, Kyle Gaffney, Christina Wagner, Kidist Maxwell, Ginu Unnikrishnan, Tyler Dant

Biology and Medicine Through Mathematics Conference

No abstract provided.

Head Impacts In Collegiate Rodeo Athletes: An Observational Study, Colton D. Carlson, Jacob Miller, Jason C. Dorman, Verle D. Valentine, Thayne A. Munce

Scholarship Pathways Program

Head Acceleration Events in Collegiate Rodeo Athletes

Colton Carlson, MS4

Mentor: Thayne Munce, PhD

Introduction: Brain health has been a growing concern across a wide range of contact sports in the last three decades. While most of the early brain health research was focused on identifying and preventing concussions, newer research has found that an accumulation of repetitive head impacts (RHI) is more predictive of long-term brain health than the number of concussions sustained. Consequently, being able to assess RHI in sports despite the lack of outward symptoms has become paramount in promoting the long-term health of athletes. While the …

Comparative Analysis Of Antegrade And Retrograde Nailing For Proximal, Shaft, And Distal Femur Fractures, Saahil Noupada

Rowan-Virtua Research Day

Background:

Antegrade and retrograde intramedullary nailing are widely used for femoral fractures, yet their relative advantages across fracture locations remain debated. This study compares union rates, time to union, malunion, and functional outcomes between approaches, stratified by AO/OTA classification.

Methods:

A systematic review of PubMed, Embase, Cochrane Library, Web of Science, and Scopus (2015 to 2025) was performed. Studies reporting outcomes of antegrade and/or retrograde nailing for proximal (31), diaphyseal (32), and distal (33) femoral fractures were included. Data on demographics, fracture classification, fixation method, and outcomes were extracted. Risk of bias was assessed using ROBINS-I. Pooled estimates were calculated …

Case Report: Anaphylaxis-Induced Cardiac Arrest Leading To Multiorgan Failure, Dhruvin Patel, Russell Mordecai, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Anaphylaxis is a severe, life-threatening hypersensitivity reaction that can rapidly progress to cardiovascular collapse and cardiac arrest. Cardiac arrest due to anaphylaxis is uncommon but associated with significant morbidity and mortality. Survivors often face complex critical care courses, including multiorgan dysfunction and challenges in neurologic prognostication following hypoxic-ischemic brain injury.

Facial Skin Discoloration After Topical Silver Sulfadiazine: A Case Report, Hannah Culleny, Philip Carhart, James Espinosa, Neel Parikh, Alan Lucerna, Henry Schuitema

Rowan-Virtua Research Day

Silver sulfadiazine (Silvadene) is a topical antimicrobial commonly used in burn management. Although generally well tolerated, excessive or prolonged application may result in cutaneous pigmentation changes due to silver deposition.

Here we present the case of a a 45-year-old woman who presented with diffuse gray-blue facial discoloration five days after sustaining a minor thermal injury. She had been prescribed topical silver sulfadiazine but applied the medication to her entire face and continued use after wound resolution. Physical examination demonstrated asymptomatic hyperpigmented gray-blue macules confined to areas of application. There were no signs of inflammation or systemic involvement. Discontinuation of the …

When Venom Isn’T The Only Threat: Roseomonas Mucosa Bacteremia Following A Snake Bite, Cyrus Davati, Kishan Patel, James A. Espinosa Md, Alan Lucerna

Rowan-Virtua Research Day

Snake bites in the ED  overall are rare in the United States. While mortality is low due to modern interventions, the sequelae - including tissue necrosis, digit amputation, and subsequent infection  remain a significant concern.  Here we present the case of a  presumptively non-venomous snakebite, which  was associated with R. mucosa bacteremia.

Molten Sugar Burn To The Dorsal Foot: A Case Highlighting Unique Thermal And Adhesive Injury Mechanisms, James Espinosa, Alan A. Lucerna

Rowan-Virtua Research Day

This brief case report emphasizes injury mechanism and anatomic vulnerability rather than burn management, as treatment of deep partial-thickness burns is well established. The clinical value of this case lies in recognizing molten sugar as a uniquely hazardous thermal agent capable of producing deceptively deep injury, particularly when contact occurs on the dorsal foot.

Shopping Cart–Related Injuries In Children: Brief Clinical Review And Public Health Implications, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Shopping cart–related injuries represent a common yet underrecognized mechanism of pediatric trauma. National estimates suggest approximately 24,000 children annually are treated in U.S. emergency departments for shopping cart–related injuries, with falls accounting for the majority of cases. Younger children, particularly those under 5 years of age, are disproportionately affected, and head and facial injuries predominate.

Objective:

To provide a concise clinical and public health review of shopping cart–related pediatric injuries, with emphasis on epidemiology, injury patterns, and opportunities for prevention within emergency department practice.

Methods

Narrative review of national injury surveillance data, prior epidemiologic studies, and consumer safety guidance addressing …

From Confirmation To Guidance: Making The Case For Intraprocedural Pocus As The Next Developmental Step In Ultrasound-Supported Shoulder Reduction A Conceptual Practice Proposal And Research Agenda, James Espinosa

Rowan-Virtua Research Day

Point-of-care ultrasound (POCUS) is well established for the diagnosis of shoulder dislocation and for the confirmation of successful reduction. However, its role during the reduction maneuver itself remains under-described. This conceptual practice proposal argues that intraprocedural POCUS represents the logical next developmental step in ultrasound-supported shoulder reduction. By introducing real-time visualization of humeral head translation during reduction attempts, clinicians may identify ineffective vectors earlier, adjust technique midstream, and potentially reduce repeated attempts or escalation of procedural sedation. This work does not present outcome data but instead proposes a practical framework, workflow model, and research agenda for intraprocedural implementation. Future study …

The Physics And Biology Of High-Risk Falls: Biomechanical Analysis And Physics Assists In Understanding Why The Threshold For High-Risk Was Lowered To 10 Feet, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background: Recent revisions to the National Guideline for the Field Triage of Injured Patients lowered the high-risk fall threshold from >20 feet  to >10 feet for all ages. Guideline changes are multifactorial and typically reflect epidemiologic registry data, injury severity trends, and systems-level performance feedback. However, biomechanical analysis assists in understanding the importance of the change.

Objective: To demonstrate that a 10-foot fall generates sufficient kinetic energy and deceleration forces to exceed structural tolerance thresholds in multiple human tissues, and to show that fundamental physics independently supports the recent trauma protocol change.

Methods: Application of gravitational motion equations (v = …

The Epidemiology Of Sledding Injuries: Clinical Patterns And Public Health Prevention Strategies, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background: Sledding is a widely enjoyed winter recreational activity among children and adolescents. Although commonly perceived as low risk, sledding can result in extremity fractures, head injuries, and collision-related trauma. Emergency Departments frequently encounter sledding injuries during winter months, providing both clinical insight and opportunities for injury prevention counseling. An estimated 20,000–30,000 sledding-related injuries occur annually in the United States, most involving children and adolescents.

Objectives: To describe patterns of sledding injuries presenting to the Emergency Department and highlight practical safety recommendations physicians can communicate to families.

Methods: Conceptual review integrating Emergency Department observational experience with published literature on pediatric …

Personalized Treatment Of Chronic Tendinopathy Using Ultrasound And Neuroimmune Markers: A Narrative Review, Rohan Phadke, Samer Salman, Kirtan Patel, Jad Wardeh, Akhil Marupudi, Rahul Kumar, Arbaz A. Momin, Alireza Tavakkoli

Department of Neurosurgery Faculty Papers

Introduction: : Chronic tendinopathy affects approximately 30% of musculoskeletal consultations, yet treatment outcomes remain inconsistent despite numerous available interventions. This variability stems from the absence of validated frameworks to match individual patients to optimal treatments based on underlying pathophysiology. To synthesize current evidence on ultrasound imaging biomarkers, neuroimmune mechanisms, and interventional therapies in chronic tendinopathy, and propose a clinically applicable framework integrating ultrasound phenotyping with neuroimmune assessment to guide personalized treatment selection. Methods: A systematic literature search was conducted across PubMed, Scopus, and Web of Science through December 2025. Studies examining ultrasound/elastography imaging, neuroimmune mechanisms, or treatment interventions in chronic …

Adhesion Of Antibiotic-Resistant Bacteria To Thermoplastic Materials Used In Fabricating Medical Devices: Patient Consequences, Dev V. Mehta

Poster Presentations

Burn injury patients wear supportive orthoses made by heat-forming sheets of thermoplastic material (Figs. 1 & 2). Bacteria cause severe soft tissue infections in patients wearing contaminated orthoses. Thermoplastic medical devices can develop biofilms that include antibiotic-resistant (AR) bacteria, which significantly reduces the number of available treatment options. A biofilm is a community of microorganisms that share resources allowing them to exist in a nutrient-limited environment. Biofilm microbes secrete extracellular polymeric substance (EPS) that attaches them firmly to a substrate surface while protecting them from harmful substances, including antibiotics. Bacteria living within biofilms on inanimate surfaces can survive for extended …

Comparative Investigation Of Bacterial Adhesion On Medical Device Thermoplastics, Dev V. Mehta

Honors Theses

This project will focus on determining if differences in bacterial cell wall composition influences adhesiveness to thermoplastic materials used to construct patient orthotic splints. Bacteria with decreased adhesion are unable to remain bonded to orthotic splints, increasing its ability to transfer to a patient’s wound, leading to an infection. Antibiotic resistant bacteria used in this investigation included gram-positive cocci vancomycin-resistant (VRE) Enterococcus faecalis, methicillin-resistant Staphylococcus aureus (MRSA), and gram-negative rods extended-spectrum beta-lactamase (ESBL) Escherichia coli and Pseudomonas aeruginosa. Each test bacterium is a major pathogen causing healthcare-associated infections (HAIs). Saline, artificial perspiration, and ascites fluids were used to determine the …

The Impact Of Normothermic Regional Perfusion Compared With Cold Storage On Warm Ischemia Time In Donation After Circulatory Death Organ Transplantation: A Scoping Review, Chris Turner

Student Works

ABSTRACT

2.Structured summary:

Background: Donation after circulatory death (DCD) has expanded the donor pool but introduces an inevitable period of warm ischemia that threatens graft viability. Preservation techniques such as normothermic regional perfusion (NRP) and static cold storage (SCS) aim to minimize this injury and improve transplant outcomes.

Objective: This scoping review identifies and synthesizes published evidence comparing NRP with SCS in DCD organ transplantation, focusing on their respective effects on warm ischemia time, graft function, and early post‑transplant outcomes.

Methods: Following the PRISMA‑ScR framework [23], searches were conducted in MEDLINE, PubMed, Embase, and Scopus for English‑language studies involving DCD …

Albumin Use In Cardiopulmonary Bypass Pump Prime And Its Association With Postoperative Renal Function And Acute Kidney Injury: A Scoping Review, Hannah Talbot

Student Works

ABSTRACT

1.Structured summary:

Background: Cardiopulmonary bypass (CPB) is associated with significant hemodilution, inflammatory activation, and alterations in renal perfusion, all of which may contribute to postoperative acute kidney injury (AKI). Albumin is frequently used as a component of CPB pump prime due to its oncotic properties and potential to mitigate fluid shifts and support intravascular volume. However, the extent to which albumin-containing priming solutions influence postoperative renal outcomes remains unclear.

Objective: This scoping review aimed to map the available literature examining the use of albumin in CPB pump prime and its reported effects on renal function and the incidence …

Clinical Applications Of Topical Platelet-Rich Plasma In Cardiac Surgery: A Scoping Review, Jaron M. Davis

Student Works

Background: Postoperative wound complications persist as a significant challenge within adult cardiac surgery. Deep and superficial sternal wound infections, along with complications at saphenous vein harvest sites, are linked to increased morbidity, extended hospital stays, and substantial healthcare expenses. Topical platelet-rich plasma (PRP), commonly known as platelet gel, has been suggested as a biologically active adjunct that may facilitate tissue repair and mitigate postoperative complications. While PRP has garnered attention in surgical practice, the overall scope and consistency of the supporting evidence in cardiac surgery remain ambiguous.

Objective: The purpose of this scoping review is to map and describe the …

Acute Compartment Syndrome Following Lower Leg Vascular Injury: A Big-Data Approach To Estimating Incidence And Risk Factors, Harry Moroz, Edward J. Harvey, Yasser C. Bouklouch

Journal of Shock and Hemodynamics

Acute Compartment Syndrome (ACS) is a limb- and life-threatening complication of lower leg fractures. Rapid recognition and fasciotomy can prevent irreversible ischemic injury, but ACS is often under-recognized. Vascular injury may increase the risk of ACS by impairing perfusion and exacerbating swelling. This study aimed to determine the incidence, risk factors, and outcomes of ACS in patients with lower leg fractures, with particular emphasis on the impact of vascular injury. This retrospective cohort study used data from the 2017 American College of Surgeons Trauma Quality Programs database to perform a multicenter analysis of patients with lower leg fractures. Patients were …