Radiographic examination and outcome in consecutive feline trauma patients

SummaryUsing univariate analysis, the correlation between signalment, history, outcome and radiographic diagnosis made on whole-body radiographs was investigated in 100 consecutive feline trauma patients of an urban clinic. The radiographic findings included: 53 thoracic injuries, 39 abdominal injuries, 34 pelvic injuries, 28 soft tissue injuries, 26 spinal injuries, and 19 cases with signs of hypovolemia. Only four radiographs were considered normal. Surgical intervention was carried out in 51 cases. Of the 100 cases, 73 survived, 23 were euthanatized, and four died. A significant positive correlation with euthanasia was found when compared to patient age (p=0.0059), abdominal trauma (P=0.0500), spinal fractures (P=0.0468), and soft tissue injuries (P=0.0175). A significant negative correlation with survival was found when compared to patient age (P=0.0358), abdominal trauma (P=0.0439), intraperitoneal free air (P=0.0041), and soft tissue injury (P=0.0288). The results of this study indicate that whole-body radiographs are useful in detecting injury in the thorax, abdomen, spine, pelvis and soft tissues, and are valuable in the diagnostic work-up of feline trauma patients.

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PROFILE OF PLASTIC SURGERY TRAUMA PATIENTS AT H. ADAM MALIK GENERAL HOSPITAL MEDAN

10.36106/gjra/7807481 ◽

2019 ◽

pp. 1-4

Author(s):

Darwin Firmansyah Siregar ◽

Frank Bietra Buchari ◽

Utama Abdi Tarigan ◽

Aznan Lelo

Keyword(s):

Soft Tissue ◽

Plastic Surgery ◽

Bone Fractures ◽

Soft Tissue Injuries ◽

Facial Trauma ◽

Trauma Patients ◽

Adult Age ◽

Common Etiology ◽

Tissue Injuries ◽

Age Range

Introduction: According to data from Perhimpunan Dokter Bedah Plastik Rekonstruksi dan Estetik Indonesia (PERAPI), there are only 193 plastic surgeons throughout Indonesia. There is no sufcient data that described pattern of incidence, workload, and role of Plastic Surgery in trauma cases at Indonesian Referral Center Hospital, especially in the Province of North Sumatra. Methods: This research is a descriptive study with a retrospective approach. Sample of this study was medical records of trauma patients who required Plastic Surgery who came to the H. Adam Malik General Hospital Medan Emergency Room (1 January 2016-31 December 2018). This study used total sampling method. Results: This study involved 536 patients and 40.85% included in the adult age range. Men vs women ratio is 3:1 (405 vs 131). Based on type of injury, the most common injury is facial trauma, followed by burns and soft tissue injuries (291, 178 and 66). The most common etiology is trafc accidents (90 cases). Most of facial bone fractures located at mandibular bone (segmental fracture). Inhalation trauma due to burns only occurred in 6 cases (3.24%). Most of soft tissue injuries occurred at lower extremities (upper limbs). Conclusion: Trafc accidents are the most common etiology for trauma in Plastic Surgery. Most of the patients are men and included in the adult age range. Facial trauma is the most common injury in Plastic Surgery. Most facial bone fractures located at mandible (symphysis and parasymphysis). Most of burns injury are re burns. Most soft tissue injuries are located at lower extremities (upper limbs).

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Facial Soft Tissue Injuries as an Aid to Ordering a Combination Head and Facial Computed Tomography in Trauma Patients

Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.joms.2004.10.009 ◽

2005 ◽

Vol 63 (5) ◽

pp. 651-654 ◽

Cited By ~ 19

Author(s):

Eric P. Holmgren ◽

Eric J. Dierks ◽

Leon A. Assael ◽

R. Bryan Bell ◽

Bryce E. Potter

Keyword(s):

Computed Tomography ◽

Soft Tissue ◽

Soft Tissue Injuries ◽

Trauma Patients ◽

Facial Soft Tissue ◽

Tissue Injuries

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Facial soft tissue injuries as an aid to ordering a combination head/facial CT in trauma patients

Journal of Oral and Maxillofacial Surgery ◽

10.1016/s0278-2391(03)00519-6 ◽

2003 ◽

Vol 61 (8) ◽

pp. 32

Author(s):

Eric Holmgren ◽

E.J. Dierks ◽

L. Homer ◽

B. Potter

Keyword(s):

Soft Tissue ◽

Soft Tissue Injuries ◽

Trauma Patients ◽

Facial Soft Tissue ◽

Tissue Injuries

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SOFT TISSUE INJURIES OF THE FACE: EARLY AESTHETIC RECONSTRUCTION IN POLY TRAUMA PATIENTS

10.36106/ijsr/1824682 ◽

2021 ◽

pp. 58-61

Author(s):

RK Jain ◽

Nitesh Lamoria

Keyword(s):

Soft Tissue ◽

Composite Structures ◽

Wound Care ◽

Primary Repair ◽

Soft Tissue Injuries ◽

Trauma Patients ◽

Facial Soft Tissue ◽

Study Results ◽

The Face ◽

Tissue Injuries

INTRODUCTION One of the most challenging and common problem faced by the plastic surgeons in polytrauma ward are Facial Soft tissue injuries, which can be completely isolated or be in combination with other injuries .The face consists of several organs and aesthetic units. The nal outcome depends on initial wound care and primary repair. So one should know the “do's and don'ts”. Disgurement following trauma, becomes a social stigma and has the gross detrimental effect on the personality and future of the victim. Therefore, such cases are most appropriately managed by Plastic Surgeons who have a thorough knowledge of applied anatomy, an aesthetic sense and meticulous atraumatic tissue handling expertise, coupled with surgical skill to repair all the composite structures simultaneously. METHOD This study is conducted in the department of Plastic and Reconstructive surgery, SMS Medical College & Hospital Jaipur India from January 2019 to December 2020. 50 patients with history of facial soft tissue injuries who were admitted in the polytrauma ward are included in the study. RESULTS Seventy-ve percent of the facial injuries were repaired primarily and the remainder were reconstructed with skin grafts or local aps from adjacent tissues. We had no post-operative infection, hematoma, ischemia, or necrosis in our patients and the patients were satised after the operation. CONCLUSION The study concludes that Primary reconstruction should be the mainstay of management and the most important responsibility of the surgeon is to convert the contaminated wound to a clean one and then to perform reconstruction.

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Diagnostic value and forensic relevance of a novel photorealistic 3D reconstruction technique in post-mortem CT

British Journal of Radiology ◽

10.1259/bjr.20200204 ◽

2020 ◽

Vol 93 (1112) ◽

pp. 20200204

Author(s):

Judith Böven ◽

Johannes Boos ◽

Andrea Steuwe ◽

Janna Morawitz ◽

Lino Morris Sawicki ◽

...

Keyword(s):

Soft Tissue ◽

3D Reconstruction ◽

Foreign Bodies ◽

Soft Tissue Injuries ◽

Fracture Dislocation ◽

Whole Body ◽

Reconstruction Technique ◽

Reconstruction Method ◽

Post Mortem ◽

Tissue Injuries

Objectives: Evaluation of performance and forensic relevance of a novel, photorealistic, 3D reconstruction method (cinematic rendering, (CR)) in comparison with conventional post-mortem CT (PMCT) and volume rendering (VR) technique for visualization of traumatic injuries. Methods: 112 pathologies (fractures, soft tissue injuries and foreign bodies) from 33 human cadavers undergoing whole body PMCT after traumatic death were retrospectively analyzed. Pathologies were reconstructed with CR and VR techniques. Fractures were classified according to their dislocation. Images were evaluated according to their expressiveness and judicial relevance by two forensic pathologists using a five-level Likert-scale (1: high expressiveness, 5: low expressiveness). They decided whether CR reconstructions were suitable for judicial reviews. The detection rate of pathologies was determined by two radiologists. Results: CR was more expressive than VR for all three trauma categories (p < 0.01) and than conventional CT when used for fractures with dislocation (p < 0.001), injuries of the ventral body surface (p < 0.001), and demonstration of foreign bodies (p = 0.033). CR and VR became more expressive with a higher grade of fracture dislocation (p < 0.001). 20% of all pathologies in the CR and VR reconstructions were not detectable by radiologists. Conclusion: CR reconstructions are superior to VR regarding the expressiveness. For fractures with substantial dislocation, soft tissue injuries, and foreign bodies in situ, CR showed a significantly better expressiveness than conventional PMCT. CR and VR have significant limitations in cases of fractures with minor dislocations and covered soft tissue injuries. Advances in knowledge: CR is a helpful tool to present pathologies found in PMCT for judicial reviews.

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Seatbelt Sign as an Indication for Four-vessel Computed Tomography Angiogram of the Neck to Diagnose Blunt Carotid Artery and Other Cervical Vascular Injuries

The American Surgeon ◽

10.1177/000313481307901009 ◽

2013 ◽

Vol 79 (10) ◽

pp. 1001-1004 ◽

Cited By ~ 4

Author(s):

Ramandeep Singh Dhillon ◽

Cristobal Barrios ◽

Cecilia Lau ◽

Jacqueline Pham ◽

Nicole Bernal ◽

...

Keyword(s):

Computed Tomography ◽

Soft Tissue ◽

Carotid Artery ◽

Injury Severity ◽

Soft Tissue Injuries ◽

Trauma Patients ◽

Positive Finding ◽

Vascular Injuries ◽

Trauma Imaging ◽

Tissue Injuries

Computed tomography angiography (CTA) of the neck has become the most common modality for diagnosing blunt carotid artery injury (BCAI). The protocol at our institution includes CTA on trauma patients with a seatbelt sign. The purpose of this study is to evaluate whether a solitary seatbelt sign is an indication for CTA of the neck to diagnose BCAI. We conducted a retrospective review of patients from 2000 to 2010 who received CTAs as a result of a seatbelt sign performed at our Level I trauma center. Four hundred eighteen patients received CTAs based on the presence of a seatbelt sign. Two hundred twenty-six had skeletal injuries, obvious soft tissue injuries, and/or positive findings on imaging, including 11 positive vascular findings with two BCAIs found. Patients with noncarotid vascular injuries on CTA had a higher Injury Severity Score than patients with solitary seatbelt signs (11.4 ± 7.6 vs 3.4 ± 4.2, P < 0.01). The correlation between seatbelt sign and positive finding on CTA was weak ( r = 0.007). Patients with vascular findings on CTA also had obvious hard/soft tissue injuries and/or positive findings on standard trauma imaging. This suggests that a protocol for CTA of the neck for patients with a seatbelt sign can be reserved for those with associated injuries on physical examination and/or findings on standard trauma imaging.

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738 Missed Injuries in Trauma Patients Attending a London Trauma Centre

British Journal of Surgery ◽

10.1093/bjs/znab134.322 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

P Johnston ◽

M Durand-Hill ◽

D I Ike ◽

I Drummond ◽

A Vris

Keyword(s):

Soft Tissue ◽

Soft Tissue Injuries ◽

Trauma Centre ◽

Trauma Patients ◽

Diagnostic Challenge ◽

Missed Injuries ◽

Tissue Injuries ◽

Neurological Injuries

Abstract Introduction Patients attending following trauma present a diagnostic challenge. Missed injuries may lead to increased morbidity, mortality and length of hospital stay. We reviewed the incidence of and contributing factors to missed injuries in trauma patients attending a London Trauma Centre. Method The records of all trauma patients admitted to a London Trauma Centre during September 2019 were studied to determine the extent and type of missed injuries. Missed injuries were classified as: Type 1 – missed during initial management (on primary and secondary survey) or Type 2 – missed on primary, secondary, and tertiary survey, but detected prior to discharge. Results Forty-two (42.4%) of 99 patients (24 Female, 75 Male) had 63 missed injuries (an average of 1.5 missed injuries per patient). Thirty-seven type 1 missed injuries occurred (5 fractures, 28 soft tissue injuries, 4 neurological injuries). Twenty-six type 2 missed injuries occurred (13 fractures, 7 soft tissue injuries, 3 neurological injuries and 3 visceral injuries). Conclusions Significant injuries can be missed despite primary, secondary, and tertiary surveys in trauma patients. Clinicians involved in the care of trauma patients should therefore remain alert to evolving/new injuries throughout hospital admission.

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Retrospective Cohort Study of Frequency and Patterns of Orbital Injuries on Whole-Body CT with Maxillofacial Multi-Slice CT

Tomography ◽

10.3390/tomography7030033 ◽

2021 ◽

Vol 7 (3) ◽

pp. 373-386

Author(s):

Leonie Goelz ◽

Annika Syperek ◽

Stephanie Heske ◽

Sven Mutze ◽

Norbert Hosten ◽

...

Keyword(s):

Cohort Study ◽

Soft Tissue ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Soft Tissue Injuries ◽

Severe Trauma ◽

Whole Body ◽

Ocular Motility ◽

Case Review ◽

Tissue Injuries

Background: High-impact trauma frequently leads to injuries of the orbit, but literature focusing on the viscerocranium rather than the neurocranium is underrepresented. Methods: Retrospective cohort study (2006–2014) at an urban level 1 trauma center assessing the frequency and typical patterns of orbital injuries on whole-body computed tomography (WBCT) with maxillofacial multi-slice CT (MSCT) after severe trauma. (1) Screening of consecutive WBCT cases for dedicated maxillofacial MSCT. (2) Examination by two independent experts’ radiologists for (peri-/)orbital injuries. (3) Case review for trauma mechanisms. Results: 1061 WBCT were included revealing 250 (23.6%) patients with orbital injuries. Less than one-quarter (23.3%) of patients showed osseous and 9.5% showed soft tissue injuries. Combined osseous and soft tissue lesions were present in 39.2% of orbital injuries, isolated soft tissue injuries were rare. Single- or two-wall fractures of the orbit were prevalent, and the orbital floor was affected in 67% of fractures. Dislocated extraocular muscles (44.6%), deformation of the ocular globe (23.8%), and elongation of the optic nerve (12.9%) were the most frequently soft tissue findings. Vascular trauma was suspected in 15.8% of patients. Conclusions: Orbital trauma was confirmed in 23.6% of cases with suspected facial injuries after severe trauma. Concomitant soft tissue injuries should be excluded explicitly in cases with orbital fractures to prevent loss of vision or ocular motility.

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