Blunt major trauma: now two different diseases?

2020 ◽  
Vol 81 (4) ◽  
pp. 1-3
Author(s):  
Timothy Coats

Major trauma in the UK has changed and can now be thought of as two different diseases: the traditional type of high energy transfer major trauma occurring in younger patients, and low energy transfer major trauma (usually an older person falling on one level). The current NHS trauma system is not well set up to treat low energy transfer major trauma – adapting to the changing disease is the next big challenge.

Author(s):  
Michael C. Reade ◽  
Peter D. Thomas

Bullets and other projectiles cause ballistic trauma. Explosions wound by the effect of a blast pressure wave, penetrating fragments propelled by the explosion, the mass movement of gas interacting with the casualty or the environment, and miscellaneous effects. Most blast casualties surviving to hospital care will not have significant pressure wave injury, but some will. Blast fragmentation most commonly resembles other types of low energy transfer ballistic trauma.. The effect of bullets depends on the kinetic energy transferred and the nature of the tissues struck, with energy transfer partly determined by bullet design. Low energy transfer bullets wound by crushing and laceration, limited to the tissues struck. High energy bullets may impart kinetic energy to surrounding tissues, causing a temporary cavity which sucks in debris and damages tissues sometimes well beyond the bullet track. Predicting the extent of devitalization can be difficult at the time of initial inspection. Wound contamination, particularly with soil, may modify the usual conservative approach to initial debridement.


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Vol 58 (10) ◽  
pp. 1660-1671 ◽  
Author(s):  
Yi Lu ◽  
HengNian Li ◽  
JiSheng Li ◽  
Zheng Che ◽  
YiKang Yang ◽  
...  

1998 ◽  
Vol 639 (3-4) ◽  
pp. 733-747 ◽  
Author(s):  
C. Angulo ◽  
P. Descouvemont

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Vol 30 (6) ◽  
pp. 966-972 ◽  
Author(s):  
Ya-Min Wang ◽  
Dong Qiao ◽  
Ping-Yuan Cui

2000 ◽  
Vol 63 (4) ◽  
pp. 548-550 ◽  
Author(s):  
E. V. Lychagin ◽  
A. Yu. Muzychka ◽  
V. V. Nesvizhevsky ◽  
G. V. Nekhaev ◽  
R. R. Tal’daev ◽  
...  

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