scholarly journals The role of plastic and reconstructive surgeon in trauma care: Perspectives from a Level 1 trauma centre in India

2018 ◽  
Vol 51 (02) ◽  
pp. 170-176
Author(s):  
Maneesh Singhal ◽  
Ravikiran Naalla ◽  
Aniket Dave ◽  
Moumita De ◽  
Deepti Gupta ◽  
...  
Keyword(s):  
Trauma Care ◽  
Demographic Data ◽  
Maxillofacial Surgery ◽  
Trauma Centre ◽  
Care Facilities ◽  
Integral Role ◽  
Burn Surgery ◽  
Post Traumatic ◽  
Level 1

ABSTRACT Background: As the morbidity and mortality due to trauma are ever increasing, there is proportionally growing need of trauma care facilities across the country. In the context of expanding designated trauma care facilities, the role of plastic and reconstructive surgeon needs to be analysed and defined at least at a Level 1 trauma centre. Materials and Methods: We included the patients who were operated under the department of plastic, reconstructive & burns surgery at a Level 1 urban trauma centre between January 2016 and December 2017. We analysed the demographic data and categorised operative data according to anatomical areas and interacting specialties. Results: A total of 1539 procedures were performed under the division of plastic reconstructive and burn surgery. Amongst them, 81% were male, and 19% were female. Mean age was 27.3 years (range: 3–90 years). The anatomical locations treated were upper limb (49%), lower limb (35%), head and neck (8%) and trunk (8%). Interdepartmental cases were 600 and majority of them were in collaboration with orthopaedics (n = 298), general surgery (n = 163), neurosurgery (79) and maxillofacial surgery (60). Conclusion: There is a significant role of plastic surgeon at a Level 1 trauma centre in India. The plastic surgeon's interventions are limb saving and sometimes lifesaving, many at times morbidity of post-traumatic sequelae are either prevented or treated. Along with other core specialties involved in the management of trauma, plastic surgeons play an integral role in a Level 1 trauma centre. The policymakers should take note to augment the number of plastic surgeons at a Level 1 apex trauma centre on par with other specialties, as the workload is heavy and is steadily on an increasing trend.

scholarly journals Trauma 2021Perceptions of a trauma team regarding in situ simulationEpidemiology of submersion injuries in Canadian children and adolescents: 1990–2018A survey of medical and administrative directors on REBOA use in Canadian trauma centresCut to the chase: comparing cutting tools in the exposure of simulated trauma patientsPediatric major trauma. Anaesthesia education: airway, breathing, coffee and cases 2020–2021Geriatric trauma care at a level 1 trauma centre: Are we following best practice?Was the introduction of a provincially standardized consensus statement for postintubation analgesia and sedation associated with increased use of associated pharmacological therapies in New Brunswick?Are there important variations in the care of adult trauma patients with isolated, nonoperative subdural hematomas between those admitted to a neurosurgical centre and those admitted to a non-neurosurgical centre for their entire inpatient stay?Flattening the curve on the negative psychosocial impact of trauma on the family of acute care trauma survivors: a quantitative studyDoes ACLS belong in ATLS? Seeking evidence during resuscitative thoracotomyAutologous omental harvest for microvascular free flap reconstruction of a severe traumatic scalp degloving injury: a case reportDerivation and validation of actionable quality indicators targeting reductions in complications for injury admissionsASA dosing practices in the management of blunt cerebrovascular injury: a retrospective reviewA retrospective analysis of bicycle lane collisions in Vancouver, British Columbia, from 2012 to 2017Evaluating the Screening, Brief Intervention and Referral to Treatment (SBIRT) process at Vancouver General HospitalAlcohol use and trauma in Alberta after COVID-19 lockdown: overrepresentation and undertreatment are opportunities for improvementMental health and addiction diagnoses are linked to increased violent injuries and gaps in provision of resources during the COVID-19 pandemicPain management strategies after orthopedic trauma in a level 1 trauma centre: a descriptive study with a view of optimizing practicesStudy to Actively Warm Trauma Patients (STAY WARM): a feasibility pilot evaluationPrehospital trauma care in civilian and military settings including cold environments: a systematic review and knowledge gap analysisAntibiotic administration in open fractures: adherence to guidelines at a Canadian trauma centreAre we meeting massive transfusion protocol activation and blood product delivery times in trauma patients? A retrospective review from 2014 to 2018Unplanned returns to the operating room: a quality improvement initiative at a level 1 trauma centreStopping the bleed: the history and rebirth of Canadian freeze-dried plasmaThe state of the evidence for emergency medical services (EMS) care of prehospital severe traumatic brain injury: an analysis of appraised research from the Prehospital Evidence-based Practice programA mixed methods study of a paramedic falls referral program in Nova ScotiaFirst presentations of psychiatric illness at a level 1 trauma centreAlcohol and substance abuse screening in pediatric trauma patients: examining rates of screening and implementing a screen for the pediatric populationMeasuring behavioural quality and quantity of team leaders during simulated interprofessional trauma careImproving rural trauma outcomes: a structured trauma-training program for rural family physicians with enhanced surgical skills — a pilot projectTrauma treatment: evidence-based response to psychological needs after a natural disasterHow prepared are Canadian trauma centres for mass casualty incidents?The catalytic effect of multisource feedback for trauma teams: a pilot studyRetrievable inferior vena cava filter for primary prophylaxis of pulmonary embolism in at-risk trauma patients: a feasibility trialValue of data collected by the medical examiner service on the quality of alcohol and toxicology testing in fatal motor vehicle collisionsPrehospital narrow pulse pressure predicts need for resuscitative thoracotomy and emergent surgical intervention after traumaImpact of a geriatric consultation service on outcomes in older trauma patients: a retrospective pre–post studyExploring physical literacy as a condition of fall mechanism in older adultsIs the use of business intelligence software helpful in planning injury prevention campaigns?Exposure to endotracheal intubation among trauma patients in level 5 trauma centres in New Brunswick — a retrospective reviewAre early specialist consultations helpful predictors of those who require care in level 1 or 2 designated trauma centres?Neurologic outcomes after traumatic cardiac arrest: a systematic reviewClosed-loop communication in the trauma bay: identifying opportunities for team performance improvement through a video review analysisEmbolization in nonsplenic trauma: outcomes at a Canadian trauma hospitalThe matrix: grouping ICD-10-CA injury codes by body region and nature of injury for reporting purposesEvaluation of low-value clinical practices in acute trauma care: a multicentre retrospective studyTrauma 101: a virtual case-based trauma conference as an adjunct to medical educationPhysiologic considerations, indications and techniques for ECLS in trauma: experience of a level 1 trauma centreEngaging patients in the selection of trauma quality indicatorsStrategies aimed at preventing chronic opioid use in trauma and acute care surgery: a scoping reviewAugmented reality surgical telementoring for leg fasciotomyIdentification of high-risk trauma patients requiring major interventions for traumatic hemorrhage: a prospective study of clinical gestaltEvaluating best practices in trauma care of older adultsBetween paradigms: comparing patient and parent experiences of injured adolescents treated at pediatric or adult trauma centresEarly outcomes after implementation of chest trauma management protocol in Vancouver General HospitalUtility of diagnostic peritoneal lavage versus focused abdominal sonography for trauma in penetrating abdominal injuryTime to definitive surgery and survival in pediatric patients younger than 18 years with gunshot woundsThe effect of chronic obstructive lung disease on post-traumatic acute respiratory distress syndrome: predictors of morbidity and mortalityThe association between injury type and clinical outcomes in patients with traumatic renal injury after nephrectomyWhen low complication rates are a bad sign: the negative impact of introducing an electronic medical record on TQIP data completenessClinical handover from paramedic services to the trauma team: a video review analysis of the IMIST-AMBO protocol implementationGeriatric Recovery and Enhancement Alliance in Trauma (GREAT) multidisciplinary quality improvement initiative: improving process and outcome measures for geriatric trauma patientsIncreasing the safety of inadvertent iliac artery device deployment with the COBRA-OS, a novel low-profile REBOA deviceIs it better to watch before or listen while doing? A randomized trial of video-modelling versus telementoring for out-of-scope tube thoracostomy insertion performed by search and rescue medicsIndications for prehospital civilian tourniquet application by first responders: an expert consensus opinion of military physicians by the Delphi method

2021 ◽  
Vol 64 (5 Suppl 1) ◽  
pp. S37-S64
Author(s):  
Olga Bednarek ◽  
Mike O’Leary ◽  
Sean Hurley ◽  
Caleb Cummings ◽  
Ruth Bird ◽  
...  
Keyword(s):  
New Brunswick ◽  
Trauma Care ◽  
Trauma Team ◽  
Trauma Centre ◽  
Quality Improvement Initiative ◽  
Evidence Based ◽  
Trauma Patients ◽  
Trauma Outcomes ◽  
Trauma Centres ◽  
Level 1

Bioactive Glasses in Treating Bone Infections

2017 ◽  
Vol 758 ◽  
pp. 245-249
Author(s):  
Olivera Lupescu ◽  
Mihail Nagea ◽  
Alexandru Dimitriu ◽  
Iulian Vasile Antoniac
Keyword(s):  
Bone Substitutes ◽  
Trauma Centre ◽  
Inorganic Materials ◽  
Prolonged Treatment ◽  
Emotional Impact ◽  
Bioactive Glasses ◽  
Bone Infections ◽  
Post Traumatic ◽  
Level 1 ◽  
Potential Clinical Impact

Bone infections are challenging due to their difficult and prolonged treatment, considerable possibility of relapse and strong negative physical and emotional impact. Since their treatment require thorough excisions, bone substitutes have been studied for restoring bone continuity, but with limited efficacy due to the pathophysiology of bone infections; one of the classes which proved to be efficient were the BioActive Glasses [BAG], synthetic biocompatible inorganic materials with a controlled ionic release, with demonstrated properties of wound healing, osteoconduction, angiogenesis and antibacterial activity. This paper presents the clinical experience from a Level 1 Trauma Centre where post-traumatic osteitis was treated using BioActive Glasses as bone fillers, demonstrating the potential clinical impact of these materials. The outcome of the patients was favourable, with no relapse of sepsis, therefore proving the efficacy of BAG in cases with limited grafting possibilities

Rushing Gunshot Victims to Trauma Care: The Influence of First Responders and the Challenge of the Geography

2020 ◽  
Vol 24 (4) ◽  
pp. 377-397 ◽  
Author(s):  
David N. Hatten ◽  
Kevin T. Wolff
Keyword(s):  
Trauma Care ◽  
Significant Relationship ◽  
Gunshot Wound ◽  
Injury Severity ◽  
First Responders ◽  
Past Research ◽  
First Responder ◽  
Care Services ◽  
Care Facilities

Past research exploring correlates to gunshot wound fatality have focused on the distance between the victim/incident location and trauma care facilities. Far less is known regarding the role of first responders in linking individuals to trauma care services. This study introduces a new method for measuring proximity to trauma care services and first responder locations, using the STATA OSRMTIME package to assess this relationship. A positive and significant relationship was found between travel time, measured in minutes, from first responder locations and the likelihood of gunshot fatality, controlling for age, race, sex, and, injury severity.

scholarly journals Measurement of Cytokines and Adhesion Molecules in the First 72 Hours after Severe Trauma: Association with Severity and Outcome

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
António Sousa ◽  
Frederico Raposo ◽  
Sara Fonseca ◽  
Luís Valente ◽  
Filipe Duarte ◽  
...  
Keyword(s):  
Cohort Study ◽  
Outcome Assessment ◽  
Inflammatory Responses ◽  
Severe Trauma ◽  
Trauma Centre ◽  
Assessment Tools ◽  
Polytrauma Patients ◽  
Level 1 ◽  
Anti Inflammatory

Introduction. Severity and outcome assessments are crucial in trauma. Our aim was to describe the role of a group of cytokines (TNFα, IL-6, IL-10, and HMGB-1) and ICAM-1 as severity and outcome assessment tools and their kinetics in the first 72 h after severe trauma.Materials and Methods. Authors designed a prospective cohort study of severe polytrauma patients (ISS > 15) in a level 1 Trauma Centre. Cytokines and ICAM-1 levels and Th1/Th2 ratios were assessed at admission, 24, 48, and 72 h. SIRS, SIRS with hypoperfusion, and shock were identified. Outcomes considered were ICU admission, ARDS, MODS, and death.Results. Ninety-nine patients were enrolled (median ISS: 29 and age 31). There was an early release of pro- and anti-inflammatory mediators with higher values at admission (except for ICAM-1). On admission, IL-6 was associated with ISS, IL-10 with SIRS with hypoperfusion, and HMGB-1 with shock. Several cytokines were associated with outcomes, especially IL-6 and IL-10 at 72 h with MODS and death. Low TNFα/IL-10 and IL-6/IL-10 ratios at 24 and 72 h were associated with MODS and death.Conclusions. Pro- and anti-inflammatory responses occur simultaneously and earlier after injury. Cytokines may be useful for outcome assessment, especially IL-6 and IL-10. Low Th1/Th2 ratio at 24 to 72 h is associated with MODS and death.

The Role of Stress Sensitization in Progression of Post-Traumatic Distress Following Deployment

2012 ◽  
Author(s):  
Geert Smid ◽  
Rolf Kleber ◽  
Arthur Rademaker ◽  
Mirjam van Zuiden ◽  
Eric Vermetten
Keyword(s):  
Stress Sensitization ◽  
Post Traumatic ◽  
Traumatic Distress
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