Facing increased suicide attempts during COVID-19 pandemic lockdown: the experience from the major trauma center in Lombardy, Italy

Study Design Retrospective study. Objective: Following SARS-CoV-2 pandemic break-out a lockdown period for the population and a reorganization of the Health System were needed. Hub-function Centers for time-dependent diseases were identified and Niguarda Hospital (Milan) was selected as main Regional Trauma Center. The purpose of our study is to report the experience of Niguarda Maxillofacial Trauma Team during this period, pointing out epidemiological changes in the presentation of trauma in comparison to the previous 3 years. Methods: Two hundred and sixteen patients were admitted to the Emergency Department from 8th March 2020 to 8th May 2020. One hundred and eighty-one had a diagnosis of Major Trauma and 36 had also facial fractures; 35 patients had isolated facial fractures. Data were compared to the activity during the same period in 2017-2019 and statistical analysis was carried out concerning demographic and clinical characteristics, trauma dynamics and positivity to COVID-19. Results: Cumulative curves of patients admitted because of Major Trauma describe a superimposable linear trend in years 2017-2019, while 2020 shows an increase from April 16th. Average age and number of more severe patients were higher than previous years. Epidemiological changes concerned road accidents, accidents involving pedestrians and cyclists, interpersonal violence, suicide attempts and domestic accidents. The incidence of facial fractures was confirmed through years and, according to its measured severity, 75% of patients required management. COVID-19 positivity without systemic symptoms didn’t influence the type of treatment. Conclusion: The COVID-19 lockdown offers a unique opportunity to study the reversal epidemiological effects on trauma.

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The Management of Penetrating Neck Injury With Retained Knife: 15-Year Experience From a Major Trauma Center in South Africa

The American Surgeon ◽

10.1177/00031348211065127 ◽

2021 ◽

pp. 000313482110651

Author(s):

Victor Kong ◽

Cynthia Cheung ◽

Jonathan Ko ◽

William Xu ◽

John Bruce ◽

...

Keyword(s):

South Africa ◽

Operating Room ◽

Trauma Center ◽

Major Trauma ◽

Length Of Hospital Stay ◽

Neck Injury ◽

Neck Exploration ◽

Anterior Neck ◽

Penetrating Neck Injury ◽

Posterior Neck

Background This study reviews our cumulative experience with the management of patients presenting with a retained knife following a penetrating neck injury (PNI). Methods A retrospective cohort study was conducted at a major trauma center in South Africa over a 15-year period from July 2006 to December 2020. All patients who presented with a retained knife in the neck following a stab wound (SW) were included. Results Twenty-two cases were included: 20 males (91%), mean age: 29 years. 77% (17/22) were retained knives and 23% (5/22) were retained blades. Eighteen (82%) were in the anterior neck, and the remaining 4 cases were in the posterior neck. Plain radiography was performed in 95% (21/22) of cases, and computed tomography (CT) was performed in 91% (20/22). Ninety-five percent (21/22) had the knife or blade extracted in the operating room (OR). Formal neck exploration (FNE) was undertaken in 45% (10/22) of cases, and the remaining 55% (12/22) underwent simple extraction (SE) only. Formal neck exploration was more commonly performed for anterior neck retained knives than the posterior neck, although not statistically significant [56% (10/18) vs 0% (0/18), P = .096]. There were no significant differences in the need for intensive care admission, length of hospital stay, morbidities, or mortalities between anterior and posterior neck retained knives. Discussion Uncontrolled extraction of a retained knife in the neck outside of the operating room may be dangerous. Retained knives in the anterior neck commonly required formal neck exploration but not for posterior neck retained knives.

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