scholarly journals Plastic Surgery in a Trauma Center: A Multidisciplinary Approach for Polytrauma Patients

2021 ◽  
Author(s):  
Kyung-Chul Moon ◽  
Yu-Kyeong Yun
Keyword(s):  
Plastic Surgery ◽  
Trauma Center ◽  
Multidisciplinary Approach ◽  
Polytrauma Patients

scholarly journals Prehospital time and mortality in polytrauma patients: a retrospective analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
E. Berkeveld ◽  
Z. Popal ◽  
P. Schober ◽  
W. P. Zuidema ◽  
F. W. Bloemers ◽  
...  
Keyword(s):  
Patient Outcome ◽  
Emergency Medical Services ◽  
Trauma Center ◽  
Total Mortality ◽  
Medical Services ◽  
Severely Injured ◽  
Emergency Medical ◽  
Polytrauma Patients ◽  
Level I ◽  
Prehospital Time

Abstract Background The time from injury to treatment is considered as one of the major determinants for patient outcome after trauma. Previous studies already attempted to investigate the correlation between prehospital time and trauma patient outcome. However, the outcome for severely injured patients is not clear yet, as little data is available from prehospital systems with both Emergency Medical Services (EMS) and physician staffed Helicopter Emergency Medical Services (HEMS). Therefore, the aim was to investigate the association between prehospital time and mortality in polytrauma patients in a Dutch level I trauma center. Methods A retrospective study was performed using data derived from the Dutch trauma registry of the National Network for Acute Care from Amsterdam UMC location VUmc over a 2-year period. Severely injured polytrauma patients (Injury Severity Score (ISS) ≥ 16), who were treated on-scene by EMS or both EMS and HEMS and transported to our level I trauma center, were included. Patient characteristics, prehospital time, comorbidity, mechanism of injury, type of injury, HEMS assistance, prehospital Glasgow Coma Score and ISS were analyzed using logistic regression analysis. The outcome measure was in-hospital mortality. Results In total, 342 polytrauma patients were included in the analysis. The total mortality rate was 25.7% (n = 88). Similar mean prehospital times were found between the surviving and non-surviving patient groups, 45.3 min (SD 14.4) and 44.9 min (SD 13.2) respectively (p = 0.819). The confounder-adjusted analysis revealed no significant association between prehospital time and mortality (p = 0.156). Conclusion This analysis found no association between prehospital time and mortality in polytrauma patients. Future research is recommended to explore factors of influence on prehospital time and mortality.

Facial Fractures Have Similar Outcomes When Managed by Either Otolaryngology or Plastic Surgery: Encounters From a Single Level I Trauma Center

2021 ◽  
pp. 194338752110206
Author(s):  
Ashton Christian ◽  
Beatrice J. Sun ◽  
Nima Khoshab ◽  
Areg Grigorian ◽  
Christina Y. Cantwell ◽  
...  
Keyword(s):  
Plastic Surgery ◽  
Trauma Center ◽  
Demographic Data ◽  
Open Reduction Internal Fixation ◽  
Facial Fractures ◽  
Chi Square ◽  
Single Level ◽  
Baseline Characteristics ◽  
Level I ◽  
Complications And Mortality

Study Design: Retrospective cohort. Objective: Traumatic facial fractures (FFs) often require specialty consultation with Plastic Surgery (PS) or Otolaryngology (ENT); however, referral patterns are often non-standardized and institution specific. Therefore, we sought to compare management patterns and outcomes between PS and ENT, hypothesizing no difference in operative rates, complications, or mortality. Methods: We performed a retrospective analysis of patients with FFs at a single Level I trauma center from 2014 to 2017. Patients were compared by consulting service: PS vs. ENT. Chi-square and Mann-Whitney-U tests were performed. Results: Of the 755 patients with FFs, 378 were consulted by PS and 377 by ENT. There was no difference in demographic data ( P > 0.05). Patients managed by ENT received a longer mean course of antibiotics (9.4 vs 7.0 days, P = 0.008) and had a lower rate of open reduction internal fixation (ORIF) (9.8% vs. 15.3%, P = 0.017), compared to PS patients. No difference was observed in overall operative rate (15.1% vs. 19.8%), use of computed tomography (CT) imaging (99% vs. 99%), time to surgery (65 vs. 55 hours, P = 0.198), length of stay (LOS) (4 vs. 4 days), 30-day complication rate (10.6% vs. 7.1%), or mortality (4.5% vs. 2.6%) (all P > 0.05). Conclusion: Our study demonstrated similar baseline characteristics, operative rates, complications, and mortality between FFs patients who had consultation by ENT and PS. This supports the practice of allowing both ENT and PS to care for trauma FFs patients, as there appears to be similar standardized care and outcomes. Future studies are needed to evaluate the generalizability of our findings.

scholarly journals Use of flaps in orthopedics in a peripheral trauma center in Nepal without plastic surgery services

2021 ◽  
Vol 8 (2) ◽  
pp. 117
Author(s):  
BhimBahadur Shreemal ◽  
TulBahadur Pun ◽  
Dipak Maharjan ◽  
DevendraSingh Bhat
Keyword(s):  
Plastic Surgery ◽  
Trauma Center ◽  
Peripheral Trauma

A Multidisciplinary Approach to Adverse Drug Events in Pediatric Trauma Patients in an Adult Trauma Center

2009 ◽  
Vol 25 (7) ◽  
pp. 444-446 ◽  
Author(s):  
Michael Kalina ◽  
Glen Tinkoff ◽  
Wendy Gleason ◽  
Paula Veneri ◽  
Gerard Fulda
Keyword(s):  
Trauma Center ◽  
Multidisciplinary Approach ◽  
Adverse Drug Events ◽  
Pediatric Trauma ◽  
Trauma Patients

Concomitant Sternal Fracture in Flail Chest: An Analysis of 21,741 Polytrauma Patients from the TraumaRegister DGU®

2017 ◽  
Vol 65 (07) ◽  
pp. 551-559 ◽  
Author(s):  
Sebastian Krinner ◽  
Andreas Langenbach ◽  
Pascal Oppel ◽  
Rolf Lefering ◽  
Dominic Taylor ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Trauma Center ◽  
Injury Severity ◽  
Flail Chest ◽  
Inclusion Criteria ◽  
Sternal Fracture ◽  
Spine Injuries ◽  
Thorax Trauma ◽  
Polytrauma Patients ◽  
Sternal Fractures

Background Isolated sternal fractures (SFs) rarely show complications, but their influence in a thorax trauma of the seriously injured still remains unclear. Methods A retrospective analysis of the TraumaRegister DGU® was performed involving the years 2009 to 2013 (Injury Severity Score [ISS] ≥ 16, primary admission to a trauma center). Cohort formation: Unilateral and bilateral flail chest (FC) injuries with and without a concomitant SF, respectively. Results In total, 21,741 patients (25% female) met the inclusion criteria, with 3,492 (16.1%) showing SF. Unilateral FC patients were on average 53.6 ± 18.4 years old, and bilateral FC patients were on average 55.2 ± 17.7 years old. The ISS in unilateral FC and bilateral FC amounted to 31.2 ± 13.0 and 43.4 ± 13.1 points, respectively. FC with an SF occurred more frequently as an injury to car occupants and less frequently as an injury to motorcyclists or in injuries due to falls. Conclusion Patients with an SF additional to an FC had longer hospital and intensive care unit stays and were longer artificially respirated than those patients without an SF. SF indicates possible cardiac and thoracic spine injuries.

scholarly journals Orbital Surgical Guidelines: Pediatric Considerations

2021 ◽  
Vol 82 (01) ◽  
pp. 142-148
Author(s):  
Ann Q. Tran ◽  
Michael Kazim
Keyword(s):  
Optic Nerve ◽  
Skull Base ◽  
Plastic Surgery ◽  
Surgical Planning ◽  
Multidisciplinary Approach ◽  
Skull Base Surgery ◽  
Maxillofacial Surgery ◽  
Interventional Neuroradiology ◽  
Orbital Surgery ◽  
Surgical Guidelines

AbstractPediatric orbital and skull base surgery comprises a wide array of tumors. An understanding of the location of the lesion, nature of the disease, and surrounding anatomy is paramount to surgical planning in these small spaces. The goals of pediatric skull base surgery are to avoid injury to the surrounding structures, minimize cosmetic deformities, and remove some or all of the tumors based on anticipated pathology and biologic cost of removal. Safe surgery on many of these tumors requires an understanding of the location of the lesion relative to the optic nerve or orbit. This is particularly challenging because the dimensions of the orbital confines change continuously as one navigates from rostral to caudal. Management of these tumors may require a multidisciplinary approach including orbital surgery, neurosurgery, otolaryngology, oral maxillofacial surgery, plastic surgery, and interventional neuroradiology.

Wound patterns in survivors of modern firearm related civilian Mass Casualty Incidents

2019 ◽  
Vol 14 (3) ◽  
pp. 175-180
Author(s):  
Chase Knickerbocker, MS ◽  
Mario F. Gomez, DO ◽  
Jose Lozada, MD ◽  
Jonathan Zadeh, MD ◽  
Eugene Costantini, MD ◽  
...  
Keyword(s):  
Trauma Center ◽  
Multidisciplinary Approach ◽  
Mass Casualty ◽  
Medical Examiner ◽  
Fatality Rate ◽  
Mass Shootings ◽  
Fort Lauderdale ◽  
Mass Shooting ◽  
Level 1 ◽  
Level 1 Trauma Center

Background: Civilian mass shooting events (CMSE) are occurring with increased frequency. Unfortunately, our knowledge of how to respond to these events is largely based on military experience and medical examiner data. While this translational knowledge has improved our basic response to such events, it is critical that we have a better understanding of the wound patterns observed and the resources utilized in civilian mass shootings. This will allow us to better prepare our systems for future events.Methods: Patients from two consecutive CMSEs presented to the same level 1 trauma center in Fort Lauderdale, Florida. The patients received by this center were studied for their wound patterns as well as the care they received while in the hospital. This included wound patterns and severity, subspecialty interventions, and hospitalization requirements.Results: Both events produced a total of 19 victims who were brought to the center as trauma activations. The events had a combined fatality rate of 55 percent. Fifty-five percent of patients also had at least one wound to an extremity, two with major vascular injuries who had field tourniquets applied. Sixty-three percent required an orthopedic intervention and 32 percent required intensive care unit (ICU) admission, half of these with prolonged ventilator support.Conclusions: Given the number of extremity wounds in these events, we should continue the efforts championed by the stop the bleed campaign. The variety and quantity of specialties involved in the care of these patients also highlights the importance of a multidisciplinary approach to preparation and implementation of care in mass shooting events.

Incidence and etiology of mortality in polytrauma patients in a Dutch level I trauma center

2017 ◽  
Vol 24 (1) ◽  
pp. 49-54 ◽  
Author(s):  
Zainab El Mestoui ◽  
Hamid Jalalzadeh ◽  
Georgios F. Giannakopoulos ◽  
Wietse P. Zuidema
Keyword(s):  
Trauma Center ◽  
Polytrauma Patients ◽  
Level I
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