Open Abdomen Treatment for Severe Trauma

2016 ◽  
pp. 13-22
Author(s):  
Lianyang Zhang
Keyword(s):  
Open Abdomen ◽  
Severe Trauma

Abstract #522 Hypocalcemia-Hypercalcemia Pattern After Severe Trauma and Prolonged Immoblization in a Young Man

2018 ◽  
Vol 24 ◽  
pp. 118
Author(s):  
Ryan Singhi ◽  
Sri Harsha Tella ◽  
Ali Rizvi
Keyword(s):  
Severe Trauma

Acute changes in steroid biosynthesis in patients following severe trauma: the golden hour study

2019 ◽  
Author(s):  
Angela Taylor ◽  
Conor Bentley ◽  
Mark Foster ◽  
Janet Lord ◽  
Jon Hazeldine ◽  
...  
Keyword(s):  
Severe Trauma ◽  
Steroid Biosynthesis ◽  
Golden Hour ◽  
Acute Changes

Integration of CAD/CAE/RP Environment for Developing a New Product in Medical Field

2020 ◽  
Vol 38 (9A) ◽  
pp. 1276-1282
Author(s):  
Nabeel I. Allawy ◽  
Amjad B. Abdulghafour
Keyword(s):  
Maxillofacial Surgery ◽  
Essential Element ◽  
Severe Trauma ◽  
Simulation Software ◽  
Oral And Maxillofacial Surgery ◽  
Virtual Surgery ◽  
Multiple Fractures ◽  
Engineering Programs ◽  
Mesh Model ◽  
The Face

Reconstruction of the mandible after severe trauma is one of the most difficult challenges facing oral and maxillofacial surgery. The mandible is an essential element in the appearance of the human face that gives the distinctive shape of the face, holds. This paper aims to propose a methodology that allows the surgeon to perform virtual surgery by investing engineering programs to place the implant by default and with high accuracy within the mandible based on the patient's medical data. The current study involved a 35-year-old man suffering from a traffic accident in the mandible with multiple fractures of the facial bones. Basically, an identification of the steps required to perform virtual surgery and modeling images from the CBCT technology has been done by using the software proposed in the research. The implant model is designed as a mesh model, allowing the patient to return to a normal position. Moreover, an application of FEA procedures using the Solidworks simulation software to test and verify the mechanical properties of the final transplant.

Use of Damage Control and the Open Abdomen in Combat

2013 ◽  
Vol 79 (8) ◽  
pp. 747-753 ◽  
Author(s):  
Benjamin Bograd ◽  
Carlos Rodriguez ◽  
Richard Amdur ◽  
Fred Gage ◽  
Eric Elster ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Multivariate Regression ◽  
Injury Severity ◽  
Open Abdomen ◽  
Damage Control ◽  
Unit Length ◽  
Significant Risk ◽  
Hospital Length Of Stay ◽  
Study Cohort ◽  
Regression Analyses

Despite the well-documented use of damage control laparotomy (DCL) in civilian trauma, its use has not been well described in the combat setting. Therefore, we sought to document the use of DCL and to investigate its effect on patient outcome. Prospective data were collected on 1603 combat casualties injured between April 2003 and January 2009. One hundred seventy patients (11%) underwent an exploratory laparotomy (ex lap) in theater and comprised the study cohort. DCL was defined as an abbreviated ex lap resulting in an open abdomen. Patients were stratified by age, Injury Severity Score (ISS), Glasgow Coma Score (GCS), mechanism of injury, and blood product administration. Multivariate regression analyses were used to determine risks factors for intensive care unit length of stay (ICU LOS), hospital length of stay (HLOS), and the need for DCL. Mean age of the cohort was 24 ± 5 years, ISS was 21 ± 11, and 94 per cent sustained penetrating injury. Patients with DCL comprised 50.6 per cent (n = 86) of the study cohort and had significant increases in ICU admission ( P < 0.001), ICU LOS ( P < 0.001), HLOS ( P < 0.05), ventilator days ( P < 0.001), abdominal complications ( P < 0.05), but not mortality ( P = 0.65) compared with patients without DCL. When compared with the non-DCL group, patients undergoing DCL required significantly more blood products (packed red blood cells, fresh-frozen plasma, platelets, and cryoprecipitate; P < 0.001). Multivariate regression analyses revealed blood transfusion and GCS as significant risk factors for DCL ( P < 0.05). Patients undergoing DCL had increased complications and resource use but not mortality compared with patients not undergoing DCL. The need for combat DCL may be different compared with civilian use. Prospective studies to evaluate outcomes of DCL are warranted.

scholarly journals Interleukin 8 Elicits Rapid Physiological Changes in Neutrophils That Are Altered by Inflammatory Conditions

2021 ◽  
pp. 1-17
Author(s):  
Stefan Bernhard ◽  
Stefan Hug ◽  
Alexander Elias Paul Stratmann ◽  
Maike Erber ◽  
Laura Vidoni ◽  
...  
Keyword(s):  
Systemic Inflammation ◽  
Severe Trauma ◽  
Induced Response ◽  
Neutrophil Granulocytes ◽  
Inflammatory Conditions ◽  
Flow Cytometric ◽  
Time Flow ◽  
Flow Cytometric Measurement ◽  
Detailed Kinetics

A sufficient response of neutrophil granulocytes stimulated by interleukin (IL)-8 is vital during systemic inflammation, for example, in sepsis or severe trauma. Moreover, IL-8 is clinically used as biomarker of inflammatory processes. However, the effects of IL-8 on cellular key regulators of neutrophil properties such as the intracellular pH (pH<sub>i</sub>) in dependence of ion transport proteins and during inflammation remain to be elucidated. Therefore, we investigated in detail the fundamental changes in pH<sub>i</sub>, cellular shape, and chemotactic activity elicited by IL-8. Using flow cytometric methods, we determined that the IL-8-induced cellular activity was largely dependent on specific ion channels and transporters, such as the sodium-proton exchanger 1 (NHE1) and non-NHE1-dependent sodium flux. Exposing neutrophils in vitro to a proinflammatory micromilieu with N-formyl-Met-Leu-Phe, LPS, or IL-8 resulted in a diminished response regarding the increase in cellular size and pH. The detailed kinetics of the reduced reactivity of the neutrophil granulocytes could be illustrated in a near-real-time flow cytometric measurement. Last, the LPS-mediated impairment of the IL-8-induced response in neutrophils was confirmed in a translational, animal-free human whole blood model. Overall, we provide novel mechanistic insights for the interaction of IL-8 with neutrophil granulocytes and report in detail about its alteration during systemic inflammation.

scholarly journals Structured and Systematic Team and Procedure Training in Severe Trauma: Going from ‘Zero to Hero’ for a Time-Critical, Low-Volume Emergency Procedure Over Three Time Periods

2021 ◽  
Vol 45 (5) ◽  
pp. 1340-1348
Author(s):  
Maryam Meshkinfamfard ◽  
Jon Kristian Narvestad ◽  
Johannes Wiik Larsen ◽  
Arezo Kanani ◽  
Jørgen Vennesland ◽  
...  
Keyword(s):  
Injury Severity ◽  
Trauma System ◽  
Severe Trauma ◽  
Emergency Procedure ◽  
Emergency Thoracotomy ◽  
Severity Scores ◽  
Time Periods ◽  
Low Volume ◽  
Time Critical ◽  
Over Time

Abstract Background Resuscitative emergency thoracotomy is a potential life-saving procedure but is rarely performed outside of busy trauma centers. Yet the intervention cannot be deferred nor centralized for critically injured patients presenting in extremis. Low-volume experience may be mitigated by structured training. The aim of this study was to describe concurrent development of training and simulation in a trauma system and associated effect on one time-critical emergency procedure on patient outcome. Methods An observational cohort study split into 3 arbitrary time-phases of trauma system development referred to as ‘early’, ‘developing’ and ‘mature’ time-periods. Core characteristics of the system is described for each phase and concurrent outcomes for all consecutive emergency thoracotomies described with focus on patient characteristics and outcome analyzed for trends in time. Results Over the study period, a total of 36 emergency thoracotomies were performed, of which 5 survived (13.9%). The “early” phase had no survivors (0/10), with 2 of 13 (15%) and 3 of 13 (23%) surviving in the development and mature phase, respectively. A decline in ‘elderly’ (>55 years) patients who had emergency thoracotomy occurred with each time period (from 50%, 31% to 7.7%, respectively). The gender distribution and the injury severity scores on admission remained unchanged, while the rate of patients with signs on life (SOL) increased over time. Conclusion The improvement over time in survival for one time-critical emergency procedure may be attributed to structured implementation of team and procedure training. The findings may be transferred to other low-volume regions for improved trauma care.

scholarly journals Repair cell first, then regenerate the tissues and organs

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Xiao-Bing Fu
Keyword(s):  
Tissue Repair ◽  
Cell Damage ◽  
Ischemia Reperfusion ◽  
Severe Trauma ◽  
Basic Unit ◽  
Basic Process ◽  
Tissue Repair And Regeneration ◽  
Healing Tissue ◽  
Organ Repair ◽  
And Function

AbstractWound healing, tissue repair and regenerative medicine are in great demand, and great achievements in these fields have been made. The traditional strategy of tissue repair and regeneration has focused on the level of tissues and organs directly; however, the basic process of repair at the cell level is often neglected. Because the cell is the basic unit of organism structure and function; cell damage is caused first by ischemia or ischemia-reperfusion after severe trauma and injury. Then, damage to tissues and organs occurs with massive cell damage, apoptosis and even cell death. Thus, how to achieve the aim of perfect repair and regeneration? The basic process of tissue or organ repair and regeneration should involve repair of cells first, then tissues and organs. In this manuscript, it is my consideration about how to repair the cell first, then regenerate the tissues and organs.

scholarly journals Postoperative Rise of Circulating Mitochondrial DNA Is Associated with Inflammatory Response in Patients following Pancreaticoduodenectomy

2021 ◽  
pp. 1-7
Author(s):  
Niv Pencovich ◽  
Nadav Nevo ◽  
Roi Weiser ◽  
Ekaterina Bonder ◽  
Yoel Bogoch ◽  
...  
Keyword(s):  
Mitochondrial Dna ◽  
Inflammatory Response ◽  
Delayed Gastric Emptying ◽  
Clinical Course ◽  
Severe Trauma ◽  
Postoperative Fever ◽  
Postoperative Course ◽  
Cell Counts ◽  
White Blood Cell Counts ◽  
The Relationship

<b><i>Introduction:</i></b> Accumulation of plasma mitochondrial DNA (mtDNA) following severe trauma has been shown to correlate with the development of systemic inflammatory response syndrome (SIRS) and may predict mortality. Our objective was to investigate the relationship between levels of circulatory mtDNA following pancreaticoduodenectomy (PD) and the postoperative course. <b><i>Methods:</i></b> Levels of plasma mtDNA were assessed by real-time PCR of the mitochondrial genes <i>ND1</i> and <i>COX3</i> in 23 consecutive patients who underwent PD 1 day prior to surgery, within 8 h after surgery, and on postoperative day (POD)1 and POD5. The abundance of mtDNA was assessed relative to preoperative levels and in relation to parameters reflecting the postoperative clinical course. <b><i>Results:</i></b> When pooled for all patients, the circulating mtDNA levels were significantly increased after surgery. However, while a significant (at least &#x3e;2-fold and up to &#x3e;20-fold) rise was noted in 11 patients, no change in mtDNA levels was noted in the other 12 following surgery. Postoperative rise in circulating mtDNA was associated with an increased rate of postoperative fever until day 5, decreased hemoglobin and albumin levels, and increased white blood cell counts. These patients also suffered from increased rates of delayed gastric emptying. No significant differences were demonstrated in other postoperative parameters. <b><i>Conclusion:</i></b> Circulating mtDNA surge is associated with an inflammatory response following PD and may potentially be used as an early marker for postoperative course. Studies of larger patient cohorts are warranted.

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