scholarly journals Epidemiology of severe trauma patients treated by plastic surgeons: A 7-year study at a single regional trauma center in South Korea

2020 ◽  
Vol 47 (3) ◽  
pp. 223-227
Author(s):  
Joo Sung Jung ◽  
Dong Hee Kang ◽  
Nam Kyu Lim
Keyword(s):  
South Korea ◽  
Plastic Surgery ◽  
Trauma System ◽  
Severe Trauma ◽  
Facial Trauma ◽  
Trauma Patients ◽  
Trauma Centers ◽  
Common Diagnosis ◽  
Surgery Department

Background After the laws regulating emergency medicine were amended in 2012, regional trauma centers were established in South Korea. Plastic surgeons specialize in the simultaneous surgical care of patients with facial trauma, burns, and complicated wounds. The objective of this study was to evaluate the role of the plastic surgery department in treating severe trauma patients.Methods From January 2012 to December 2018, we enrolled 366 severe trauma patients with an Injury Severity Score (ISS) over 15 who received treatment by specialists in the plastic surgery department. Of these patients, 298 (81.4%) were male, and their mean age was 51.35 years (range, 6–91 years). The average ISS was 22.01 points (range, 16–75 points).Results The most common diagnosis was facial trauma (95.1%), and facial bone fracture (65.9%) was most common injury within this subgroup. Patients were referred to 1.8 departments on average, with the neurosurgery department accounting for a high proportion of collaborations (37.0%). The most common cause of trauma was traffic accidents (62.3%), and the average length of stay in the general ward and intensive care unit was 36.90 and 8.01 days, respectively. Most patients were discharged home (62.0%) without additional transfer or readmission.Conclusions Through this study, we scoped out the role of the specialty of plastic surgery in the multidisciplinary team at regional trauma centers. These results may have implications for trauma system planning.

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

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).

scholarly journals Factors Associated with the Use of Helicopter Inter-facility Transport of Trauma Patients to Tertiary Trauma Centers within an Organized Rural Trauma System

2016 ◽  
Vol 20 (5) ◽  
pp. 601-608 ◽  
Author(s):  
Kenneth Stewart ◽  
Tabitha Garwe ◽  
Naresh Bhandari ◽  
Brandon Danford ◽  
Roxie Albrecht
Keyword(s):  
Trauma System ◽  
Trauma Patients ◽  
Trauma Centers ◽  
Factors Associated

scholarly journals Effect of 2020 containment strategies on trauma workflow in Ile-de-France region: another benefit of lockdown?

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Jean-Denis Moyer ◽  
Paer-Selim Abback ◽  
Sophie Hamada ◽  
Thibault Martinez ◽  
Marie Werner ◽  
...  
Keyword(s):  
Severe Trauma ◽  
National Registry ◽  
Trauma Patients ◽  
Trauma Centers ◽  
Median Length ◽  
Main Text ◽  
Multicenter Cohort ◽  
The Social ◽  
Paris Area ◽  
Trauma Admission

Abstract Background During the SARS-CoV-2 pandemic, the French Government imposed various containment strategies, such as severe lockdown (SL) or moderate lockdown (ML). The aim of this study was to evaluate the effect of both strategies on severe trauma admissions and ICU capacity in Ile-de-France region (Paris Area). Main text We conducted a multicenter cohort-based observational study from 1stJanuary 2017 to 31th December 2020, including all consecutive trauma patients admitted to the trauma centers of Ile-de-France region participating in the national registry (Traumabase®). Two periods were defined, the “non-pandemic period” (NPP) from 2017 to 2019, and the “pandemic period” (PP) concerning those admitted in 2020. The number of ICU beds released during 2020 pandemic period (overall period, SL and ML) was estimated by multiplying difference in trauma admissions by the median length of stay during the same week of pandemic period (ICU day-beds in 2020). A 15% yearly reduction of trauma patients was observed during the PP, associated with the release of 6422 ICU day-beds in 2020. During SL and ML, the observed decrease in trauma admission was respectively 49 and 39% compared with similar dates of the NPP. The number of beds released was 1531 days-beds in SL and 679 day-beds in ML. Those reductions respectively accounted for 4.5 and 6.0% of the overall ICU admission for COVID-19 in Ile-de-France. Conclusion The lockdown strategies during pandemic resulted in a reduction of severe trauma admissions. In addition to the social distancing effect, lockdown strategies freed up an important number of ICU beds in trauma centers, available for severe COVID-19 patients.

scholarly journals Intubation concerns in maxillofacial trauma patients

2020 ◽  
Author(s):  
Kamran Khan ◽  
Jawaria Bibi ◽  
Muhammad Umar Qayyum
Keyword(s):  
Nasotracheal Intubation ◽  
Maxillofacial Surgery ◽  
Maxillofacial Trauma ◽  
Facial Trauma ◽  
Oral And Maxillofacial Surgery ◽  
Trauma Patients ◽  
Nasal Intubation ◽  
Trauma Centers ◽  
Dental Hospital ◽  
Low Rate

Introduction: In maxillofacial trauma the preferred intubation method for general anesthesia is nasotracheal intubation in most of the trauma centers. We conducted a retrospective study to review the utility of this method of intubation in maxillofacial trauma patients. We aimed to review the intra-operative and postoperative concerns and complications for nasotracheal intubation and effectiveness of this method of intubation in maxillofacial trauma patient. Methodology: This study included 56 patients of maxillofacial trauma, who were treated in our centre of Oral and Maxillofacial Surgery at Islamic International Dental Hospital, Islamabad in the period of two years, 1st January 2016 to 31st December 2017. Results: The study showed that nasal intubation is relatively more effective in isolated mandibular trauma patients. But there are difficulties regarding intubation in maxillary fractures and pan-facial trauma patients. Conclusion: Although nasotracheal method of intubation is difficult to attain in some cases, but still it is an effective method of intubation for majority of the maxillofacial trauma cases with very low rate of complications. Received: 30 Sep 2018Reviewed: 16 Nov 2018Accepted: 17 Nov 2018 Citation: Khan K, Bibi J, Qayyum MU. Intubation concerns in maxillofacial trauma patients Anaesth Pain & Intensive Care 2018;22 Suppl 1:S109-S112

scholarly journals The Current Role of Interventional Radiology in the Management of Acute Trauma Patient

2021 ◽  
Vol 38 (01) ◽  
pp. 034-039
Author(s):  
Casey M. Luckhurst ◽  
April E. Mendoza
Keyword(s):  
Interventional Radiology ◽  
Causes Of Death ◽  
Multidisciplinary Teams ◽  
Trauma Patients ◽  
Trauma Centers ◽  
Endovascular Techniques ◽  
Research And Innovation ◽  
Complex Patient ◽  
Common Causes

AbstractTrauma is one of the most common causes of death, particularly in younger individuals. The development of specialized trauma centers, trauma-specific intensive care units, and trauma-focused medical subspecialties has led to the formation of comprehensive multidisciplinary teams and an ever-growing body of research and innovation. The field of interventional radiology provides a unique set of minimally invasive, endovascular techniques that has largely changed the way that many trauma patients are managed. This article discusses the role of interventional radiology in the care of this complex patient population, and in particular how the specialty fits into the overall team management of these patients.

Palliative Care Consultations in Trauma Patients and Role of Do-Not-Resuscitate Orders: Propensity-Matched Study

2020 ◽  
Vol 37 (12) ◽  
pp. 1068-1075
Author(s):  
Alexander A. Fokin ◽  
Joanna Wycech ◽  
Jeffrey K. Katz ◽  
Alexander Tymchak ◽  
Richard L. Teitzman ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Palliative Care ◽  
Length Of Stay ◽  
Trauma Patients ◽  
Trauma Centers ◽  
Do Not Resuscitate ◽  
Palliative Care Consultation ◽  
Care Consultation ◽  
Do Not Resuscitate Orders

Objective: To delineate characteristics of trauma patients associated with a palliative care consultation (PCC) and to analyze the role of do-not-resuscitate (DNR) orders and related outcomes. Methods: Retrospective study included 864 patients from 2 level one trauma centers admitted between 2012 and 2019.  Level 1 trauma centers are designated for admission of the most severe injured patients. Palliative care consultation group of 432 patients who received PCC and were compared to matched control (MC) group of 432 patients without PCC. Propensity matching covariates included Injury Severity Score, mechanism of injury, gender, and hospital length of stay (HLOS). Analysis included patient demographics, injury parameters, intensive care unit (ICU) admissions, ICU length of stay (ICULOS), duration of mechanical ventilation, timing of PCC and DNR, and mortality. Palliative care consultation patients were further analyzed based on DNR status: prehospital DNR, in-hospital DNR, and no DNR (NODNR). Results: Palliative care consultation compared to MC patients were older, predominantly Caucasian, with more frequent traumatic brain injury (TBI), ICU admissions, and mechanical ventilation. The average time to PCC was 5.3 days. Do-not-resuscitate orders were significantly more common in PCC compared to MC group (71.5% vs 11.1%, P < .001). Overall mortality was 90.7% in PCC and 6.0% in MC ( P < .001). In patients with DNR, mortality was 94.2% in PCC and 18.8% in MC. In-hospital DNR-PCC compared to NODNR-PCC patients had shorter ICULOS (5.0 vs 7.3 days, P = .04), HLOS (6.2 vs 13.2 days, P = .006), and time to discharge (1.0 vs 6.3 days, P = .04). Conclusions: Advanced age, DNR order, and TBI were associated with a PCC in trauma patients and resulted in significantly higher mortality in PCC than in MC patients. Combination of DNR and PCC was associated with shorter ICULOS, HLOS, and time from PCC to discharge.

A comparison of adolescent penetrating trauma patients managed at pediatric versus adult trauma centers in a mature trauma system

2020 ◽  
Vol 88 (6) ◽  
pp. 725-733 ◽  
Author(s):  
Frederick B. Rogers ◽  
Michael A. Horst ◽  
Madison E. Morgan ◽  
Tawnya M. Vernon ◽  
Barbara A. Gaines ◽  
...  
Keyword(s):  
Trauma System ◽  
Penetrating Trauma ◽  
Trauma Patients ◽  
Trauma Centers

scholarly journals Nasal Bone Fractures: Differences Amongst Sub-Specialty Consultants

2020 ◽  
Vol 129 (11) ◽  
pp. 1120-1128
Author(s):  
Jason E. Cohn ◽  
Sammy Othman ◽  
Michael Toscano ◽  
Tom Shokri ◽  
Jason D. Bloom ◽  
...  
Keyword(s):  
Plastic Surgery ◽  
Bone Fractures ◽  
Nasal Bone ◽  
Retrospective Chart Review ◽  
Operative Management ◽  
Outpatient Setting ◽  
Categorical Variables ◽  
Facial Trauma ◽  
Trauma Patients ◽  
Continuous Variables

Background: Nasal fractures constitute the largest proportion of facial trauma each year, however, there is no consensus management. In this study, we investingated the role of the consultant and the functional and aesthetic outcomes of procedures performed to address nasal bone fractures. Methods: A retrospective chart review of patients who sustained nasal bone fractures was conducted from 8/1/14 through 1/23/18. Categorical variables were analyzed using chi-squared testing and Fisher’s exact test, where appropriate, while continuous variables were compared using Mann–Whitney U testing. Results: During the study period, 136 patients met inclusion criteria for full analysis. The mean age of this cohort was 47.6 ± 20.2 years with the majority identifying as African–American (53.7%) and male (67.2%). Otolaryngologists were significantly more likely to assess pre-operative nasal obstruction (100%) compared to plastic surgeons (24.1%) ( P < .001). Otolaryngology elected operative management (53.3%) at a significantly higher rate than plastic surgery (24.1%) ( P = .005). Additionally, otolaryngology was significantly more likely to manage patients in an outpatient setting (91.2%), whereas plastic surgery more commonly performed inpatient management (57.1%) ( P = .006). Plastic surgery averaged a significantly shorter amount of time from presentation to operative management (7.3 ± 10.7 days) compared to otolaryngology (20 ± 27.7) ( P = .019). Consulting service was not associated with a need for revision surgery. Conclusions: Consultants across subspecialties differ in the management of nasal bone trauma. A more standardized approach is warranted by all individuals involved in the care of maxillofacial trauma patients.

scholarly journals National trauma system establishment based on implementation of regional trauma centers improves outcomes of trauma care: A follow-up observational study in South Korea

2022 ◽  
Vol 2 (1) ◽  
pp. e0000162
Author(s):  
Kyoungwon Jung ◽  
Junsik Kwon ◽  
Yo Huh ◽  
Jonghwan Moon ◽  
Kyungjin Hwang ◽  
...  
Keyword(s):  
South Korea ◽  
Death Rate ◽  
Injury Severity ◽  
Trauma System ◽  
Trauma Centers ◽  
Middle Income ◽  
Death Rates ◽  
Middle Income Countries ◽  
National Trauma ◽  
Trauma Death

Although South Korea is a high-income country, its trauma system is comparable to low- and middle-income countries with high preventable trauma death rates of more than 30%. Since 2012, South Korea has established a national trauma system based on the implementation of regional trauma centers and improvement of the transfer system; this study aimed to evaluate its effectiveness. We compared the national preventable trauma death rates, transfer patterns, and outcomes between 2015 and 2017. The review of preventable trauma deaths was conducted by multiple panels, and a severity-adjusted logistic regression model was created to identify factors influencing the preventable trauma death rate. We also compared the number of trauma patients transferred to emergency medical institutions and mortality in models adjusted with injury severity scores. The preventable trauma death rate decreased from 2015 to 2017 (30.5% vs. 19.9%, p < 0.001). In the severity-adjusted model, the preventable trauma death risk had a lower odds ratio (0.68, 95% confidence interval: 0.53–0.87, p = 0.002) in 2017 than in 2015. Regional trauma centers received 1.6 times more severe cases in 2017 (according to the International Classification of Diseases Injury Severity Score [ICISS]; 23.1% vs. 36.5%). In the extended ICISS model, the overall trauma mortality decreased significantly from 2.1% (1008/47 806) to 1.9% (1062/55 057) (p = 0.041). The establishment of the national trauma system was associated with significant improvements in the performance and outcomes of trauma care. This was mainly because of the implementation of regional trauma centers and because more severe patients were transferred to regional trauma centers. This study might be a good model for low- and middle-income countries, which lack a trauma system.

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