Reporting of acute programme variables and exercise descriptors in rehabilitation strength training for tibiofemoral joint soft tissue injury: A systematic review

Abstract Introduction Vascularised composite allotransplantation (VCA) permits like-for-like reconstruction following extensive soft tissue injuries. The initial management of extensive soft tissue injury can lead to the development of anti-HLA antibodies through injury, transfusion and cadaveric grafting. The role of antibody-mediated rejection, donor-specific antibodies and graft rejection in the context of VCA remains unclear. This systematic review aimed to determine whether pre-operative management strategies influence immunological outcome following VCA. Method A systematic review of MEDLINE, EMBASE and CINAHL using a PRISMA-compliant methodology up to February 2019 was conducted. Pre-operative, procedural and long-term outcome data were collected and recorded for all VCA recipients on an individual patient basis. Result The search revealed 3,847 records of which 114 met inclusion criteria and reported clinical data related to 100 patients who underwent 129 VCA transplants. Trauma (50%) and burns (15%) were the most frequent indications for VCA. Of all 114 studies, only one reported acute resuscitative management. Fifteen patients (14.7%) were sensitized prior to reconstructive transplantation with an 80% incidence of acute rejection in the first post-operative year. Seven patients demonstrated graft vasculopathy, only one of whom had demonstrated panel reactive antibodies. Conclusion Currently employed acute management strategies predispose to the development of anti-HLA antibodies, adding to the already complex immunological challenge of VCA. Early appropriate care is warranted in patients with extensive soft tissue loss where the resuscitative needs should be balanced against strategies to mitigate the immunological burden, particularly as reconstructive transplantation becomes a feasible option for future soft tissue coverage. Take-home message Acute resuscitative management may sensitise potential transplant recipients following major soft tissue injury. Early appropriate care is warranted.

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Effect of Oral Contraceptives on Soft Tissue Injury Risk, Soft Tissue Laxity, and Muscle Strength: A Systematic Review of the Literature

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119831061 ◽

2019 ◽

Vol 7 (3) ◽

pp. 232596711983106 ◽

Cited By ~ 4

Author(s):

Jaclyn A. Konopka ◽

Lauren J. Hsue ◽

Jason L. Dragoo

Keyword(s):

Systematic Review ◽

Soft Tissue ◽

Muscle Strength ◽

Oral Contraceptives ◽

Injury Risk ◽

Tissue Injury ◽

Soft Tissue Injury ◽

Review Of The Literature ◽

Soft Tissue Laxity

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A Systematic Review of Earthquake-Related Head Injuries

Prehospital and Disaster Medicine ◽

10.1017/s1049023x19003911 ◽

2019 ◽

Vol 34 (s1) ◽

pp. s171-s171 ◽

Cited By ~ 1

Author(s):

Yutaka Igarashi ◽

Narumi Matsumoto ◽

Tatsuhiko Kubo ◽

Ryuta Nakae ◽

Shoji Yokobori ◽

...

Keyword(s):

Systematic Review ◽

Head Injury ◽

Soft Tissue ◽

Intracranial Hemorrhage ◽

Epidural Hematoma ◽

Tissue Injury ◽

Head Injuries ◽

Soft Tissue Injury ◽

Cochrane Library ◽

Mortality And Morbidity

Introduction:Earthquakes have killed around 800,000 people globally in the past 20 years, with head injury being the main cause of mortality and morbidity.Aim:To conduct a systematic review to determine the characteristics of head injuries after earthquakes for better disaster preparedness and management.Methods:All publications related to head injuries and earthquakes were searched using Pubmed, Web of Science, the Cochrane Library, and Ichushi.Results:Thirty-six articles were included in the analysis. Head injury was the third most common cause of injury among survivors of earthquakes. The most common injury after an earthquake occurred was in the lower extremities (36.2%), followed by the upper extremities (19.9%), head (16.6%), spine (13.3%), chest (11.3%), and abdomen (3.8%). Earthquake-related head injuries were predominantly caused by a blunt strike (79%), and were more frequently associated with soft tissue injury compared to non-earthquake-related head injuries and less frequently with intracranial hemorrhage. The mean age of patients with earthquake-related head injuries was 32.6 years, and 55.1% of sufferers were male. The most common earthquake-related head injury was laceration or contusion (59.2%) while epidural hematoma was most common among inpatients with intracranial hemorrhage after an earthquake (9.5%). Early wound irrigation and debridement and antibiotics administration are needed to decrease the risk of infection. Mortality due to earthquake-related head injuries was 5.6%.Discussion:Head injury was the main cause of mortality and morbidity after an earthquake. The characteristics of earthquake-related head injuries differed from those of non-earthquake-related head injuries, including the frequency of multiple injuries, and occurrence of contaminated soft tissue injury and epidural hematoma. This knowledge is important for determining demands for neurosurgery and for adequate management of patients, especially in resource-limited conditions.

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