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World Journal of Emergency Surgery: WJES

Jakob Mühlbacher, Reinhard Pauzenberger, Ulrika Asenbaum, Tobias Gauster, Stephan Kapral, Harald Herkner, Andreas Duma
Background: Early diagnosis of acute compartment syndrome (ACS) of the leg is essential to improve the outcome. Direct invasive measurement is currently recommended to measure intracompartmental pressure. A non-invasive and reproducible means of making the diagnosis would be a step forward. The purpose of this exploratory study was to investigate the feasibility of non-invasive ultrasound-guided angle measurement as a surrogate of increased pressure in a model of ACS. Methods: A model of ACS was generated by infusion of saline into the anterior compartment of the leg of human cadavers to incrementally increase the intracompartmental pressure from 10 to 100 mmHg...
2019: World Journal of Emergency Surgery: WJES
Antonio Tarasconi, Gian Luca Baiocchi, Vittoria Pattonieri, Gennaro Perrone, Hariscine Keng Abongwa, Sarah Molfino, Nazario Portolani, Massimo Sartelli, Salomone Di Saverio, Arianna Heyer, Luca Ansaloni, Federico Coccolini, Fausto Catena
Background: Nowadays, very few patients with non-variceal upper gastrointestinal bleeding fail endoscopic hemostasis (refractory NVUGIB). This subset of patients poses a clinical dilemma: should they be operated on or referred to transcatheter arterial embolization (TAE)? Objectives: To carry out a systematic review of the literature and to perform a meta-analysis of studies that directly compare TAE and surgery in patients with refractory NVUGIB. Materials and methods: We searched PubMed, Ovid MEDLINE, and Embase...
2019: World Journal of Emergency Surgery: WJES
Salma Abu Foul, Ella Egozi, Ahmad Assalia, Yoram Kluger, Ahmad Mahajna
Introduction: Prompt appendectomy has long been the standard of care for acute appendicitis in order to prevent complications such as perforation, abscess formation, and diffuse purulent or fecal peritonitis, all resulting in increased morbidity and even mortality. Our study was designed to examine whether the time from the beginning of symptoms to operation correlates with the pathological degree of appendicitis, incidence of postoperative complications, or increased length of hospital stay...
2019: World Journal of Emergency Surgery: WJES
Fikri M Abu-Zidan, Arif Alper Cevik
Background: Point-of-Care Ultrasound (POCUS) is a useful diagnostic tool. Nevertheless, it needs proper training to reach its required level of competency. Educators who work in low-income countries find it difficult to purchase expensive training computer-based simulators. We aim in this communication to describe the methods to build up and use an efficient, simple, and cheap simulator which can be used for teaching POCUS globally. Methods: It took our group 2 years to develop the simulator to its current form...
2019: World Journal of Emergency Surgery: WJES
Massimo Sartelli, Xavier Guirao, Timothy C Hardcastle, Yoram Kluger, Marja A Boermeester, Kemal Raşa, Luca Ansaloni, Federico Coccolini, Philippe Montravers, Fikri M Abu-Zidan, Michele Bartoletti, Matteo Bassetti, Offir Ben-Ishay, Walter L Biffl, Osvaldo Chiara, Massimo Chiarugi, Raul Coimbra, Francesco Giuseppe De Rosa, Belinda De Simone, Salomone Di Saverio, Maddalena Giannella, George Gkiokas, Vladimir Khokha, Francesco M Labricciosa, Ari Leppäniemi, Andrey Litvin, Ernest E Moore, Ionut Negoi, Leonardo Pagani, Maddalena Peghin, Edoardo Picetti, Tadeja Pintar, Guntars Pupelis, Ines Rubio-Perez, Boris Sakakushev, Helmut Segovia-Lohse, Gabriele Sganga, Vishal Shelat, Michael Sugrue, Antonio Tarasconi, Cristian Tranà, Jan Ulrych, Pierluigi Viale, Fausto Catena
Skin and soft-tissue infections (SSTIs) encompass a variety of pathological conditions that involve the skin and underlying subcutaneous tissue, fascia, or muscle, ranging from simple superficial infections to severe necrotizing infections. SSTIs are a frequent clinical problem in surgical departments. In order to clarify key issues in the management of SSTIs, a task force of experts met in Bertinoro, Italy, on June 28, 2018, for a specialist multidisciplinary consensus conference under the auspices of the World Society of Emergency Surgery (WSES) and the Surgical Infection Society Europe (SIS-E)...
2018: World Journal of Emergency Surgery: WJES
Aidan Lyanzhiang Tan, Yi Chiong, Nivedita Nadkarni, Jolene Yu Xuan Cheng, Ming Terk Chiu, Ting Hway Wong
Background: There is increasing focus on long-term survival, function and quality-of-life for trauma patients. There are few studies tracking longitudinal changes in functional outcome over time. The goal of our study was to compare the Glasgow Outcome Scale-Extended (GOSE) at 6 months and 12 months in blunt trauma survivors with an Injury Severity Score (ISS) of more than 15. Methods: Using the Singapore National Trauma Registry 2011-2013, patients with 6-month GOSE and 12-month GOSE scores were analysed...
2018: World Journal of Emergency Surgery: WJES
Takahiro Kinoshita, Kazuma Yamakawa, Jumpei Yoshimura, Atsushi Watanabe, Yosuke Matsumura, Kaori Ito, Hiroyuki Ohbe, Kei Hayashida, Shigeki Kushimoto, Junichi Matsumoto, Satoshi Fujimi
Background: The outcomes of multiple injury patients with concomitant torso hemorrhage and traumatic brain injury (TBI) are very poor. The hybrid emergency room system (HERS) is a trauma management system designed to complete resuscitation, computed tomography (CT), surgery, angioembolization, and intracranial pressure (ICP) monitoring all in one trauma resuscitation room without patient transfer. We aimed to review the outcomes of polytrauma patients who underwent concurrent bleeding control and ICP monitoring using the HERS...
2018: World Journal of Emergency Surgery: WJES
Aziza N Al Rawahi, Fatma A Al Hinai, Jamie M Boyd, Christopher J Doig, Chad G Ball, George C Velmahos, Andrew W Kirkpatrick, Pradeep H Navsaria, Derek J Roberts
Background: Although mandatory laparotomy has been standard of care for patients with abdominal gunshot wounds (GSWs) for decades, this approach is associated with non-therapeutic operations, morbidity, and long hospital stays. This systematic review and meta-analysis sought to summarize outcomes of selective nonoperative management (SNOM) of civilian abdominal GSWs. Methods: We searched electronic databases (March 1966-April 1, 2017) and reference lists of articles included in the systematic review for studies reporting outcomes of SNOM of civilian abdominal GSWs...
2018: World Journal of Emergency Surgery: WJES
J C de Schoutheete, I Fourneau, F Waroquier, L De Cupere, M O'Connor, K Van Cleynenbreugel, J C Ceccaldi, S Nijs
Background: The present paper describes three cases where ER-REBOA® was used with partial aorta occlusion (AO), by performing a partial resuscitative endovascular balloon occlusion of the aorta or pREBOA, in an austere pre-hospital military environment.In addition, because no specific REBOA algorithm for pre-hospital environment exists yet, this paper seeks to fill this gap, proposing a new pragmatic REBOA algorithm. Methods: Belgian Special Operations Surgical Team applied REBOA in three patients according to a decisional algorithm, based on the MIST acronym used for trauma patients...
2018: World Journal of Emergency Surgery: WJES
Valerio Cozza, Gilda Pepe, Marco Cintoni, Flavio De Maio, Giuseppe Tropeano, Sabina Magalini, Gabriele Sganga, Giovanni Delogu, Daniele Gui
Background: Negative pressure wound therapy is now largely used to treat infected wounds. The prevention and reduction of healthcare-associated infections is a high priority for any Department of Health and great efforts are spent to improve infection control systems. It is assumed that vacuum-assisted closure (VAC®) dressings should be watertight and that all the secretions are gathered in a single container but there is no consistent data on air leakage and possible dispersion of bacteria from the machine...
2018: World Journal of Emergency Surgery: WJES
Hong-Xiang Lu, Jian-Hui Sun, Da-Lin Wen, Juan Du, Ling Zeng, An-Qiang Zhang, Jian-Xin Jiang
Background: Previous study revealed that rs2232618 polymorphism (Phe436Leu) within LBP gene is a functional variant and associated with susceptibility of sepsis in traumatic patients. Our aim was to confirm the reported association by enlarging the population sample size and perform a meta-analysis to find additional evidence. Methods: Traumatic patients from Southwest ( n  = 1296) and Southeast ( n  = 445) of China were enrolled in our study. After genotyping, the relationship between rs2232618 and the risk of sepsis was analyzed...
2018: World Journal of Emergency Surgery: WJES
Shaoyun Liu, Jiefeng Xu, Yuzhi Gao, Peng Shen, Senlin Xia, Zilong Li, Mao Zhang
Background: Post-cardiac arrest syndrome, which has no specific curative treatment, contributes to the high mortality rate of victims who suffer traumatic cardiac arrest (TCA) and initially can be resuscitated. In the present study, we investigated the potential of ulinastatin to mitigate multiple organ injury after resuscitation in a swine TCA model. Methods: Twenty-one male pigs were subjected to hemodynamic shock (40% estimated blood loss in 20 min) followed by cardiac arrest (electrically induced ventricular fibrillation) and respiratory suspension for 5 min, and finally manual resuscitation...
2018: World Journal of Emergency Surgery: WJES
Federico Coccolini, Fausto Catena, Yoram Kluger, Massimo Sartelli, Gianluca Baiocchi, Luca Ansaloni, Ernest Eugene Moore
Abdominopelvic trauma has been for decades classified with the AAST-OIS (American Association for the Surgery of Trauma-Organ Injury Scale) classification. It has represented a milestone. At present, the medical evolutions in trauma management allowed an incredible progress in trauma decision-making and treatment. Non-operative trauma management has been widely applied. The interventional radiological procedures and the modern conception of Hybrid and Endovascular Trauma and Bleeding Management (EVTM) led to good results in increasing the rate of patients managed non-operatively, opening new scenarios and options...
2018: World Journal of Emergency Surgery: WJES
Hiroyuki Otsuka, Toshiki Sato, Keiji Sakurai, Hiromichi Aoki, Takeshi Yamagiwa, Shinichi Iizuka, Sadaki Inokuchi
Background: Although resuscitative endovascular balloon occlusion of the aorta (REBOA) may be effective in trauma management, its effect in patients with severe multiple torso trauma remains unclear. Methods: We performed a retrospective study to evaluate trauma management with REBOA in hemodynamically unstable patients with severe multiple trauma. Of 5899 severe trauma patients admitted to our hospital between January 2011 and January 2018, we selected 107 patients with severe torso trauma (Injury Severity Score > 16) who displayed persistent hypotension [≥ 2 systolic blood pressure (SBP) values ≤ 90 mmHg] regardless of primary resuscitation...
2018: World Journal of Emergency Surgery: WJES
Ekin Ozturk, Marianne van Iersel, Martijn Mwj Stommel, Yvonne Schoon, Richard Rpg Ten Broek, Harry van Goor
Small bowel obstruction is one of the most frequent emergencies in general surgery, commonly affecting elderly patients. Morbidity and mortality from small bowel obstruction in elderly is high. Significant progress has been made in the diagnosis and management of bowel obstruction in recent years. But little is known whether this progress has benefitted outcomes in elderly patients, particularly those who are frail or have a malignancy as cause of the obstruction, and when considering quality of life and functioning as outcomes...
2018: World Journal of Emergency Surgery: WJES
Fikri M Abu-Zidan, Arif Alper Cevik
The use of point-of-care ultrasound (POCUS) by non-radiologists has dramatically increased. POCUS is completely different from the routine radiological studies. POCUS is a Physiological, On spot, extension of the Clinical examination, that is Unique, and Safe. This review aims to lay the basic principles of using POCUS in diagnosing intestinal pathologies so as to encourage acute care physicians to learn and master this important tool. It will be a useful primer for clinicians who want to introduce POCUS into their clinical practice...
2018: World Journal of Emergency Surgery: WJES
Jeffry Kashuk, Walter Biffl, Yoram Kluger, Luca Ansaloni, Fausto Catena
No abstract text is available yet for this article.
2018: World Journal of Emergency Surgery: WJES
Chia-Peng Chang, Cheng-Ting Hsiao, Chun-Nan Lin, Wen-Chih Fann
Background: Necrotizing fasciitis (NF) is a rapidly progressive infectious disease that primarily involves the fascia and subcutaneous tissue. If not promptly treated, it can lead to morbidity as well as mortality. It can affect any part of the body, most commonly the extremities. Early and aggressive surgical treatment is the proper way of management. The purpose of this study was to identify the risk factors for mortality in late amputation among NF patients that may be used in routine clinical practice to prevent mortality...
2018: World Journal of Emergency Surgery: WJES
Ramiro Manzano-Nunez, Maria F Escobar-Vidarte, Claudia P Orlas, Juan P Herrera-Escobar, Samuel M Galvagno, Juan J Melendez, Natalia Padilla, Justin C McCarty, Albaro J Nieto, Carlos A Ordoñez
Morbidly adherent placenta (MAP), which includes accreta, increta, and percreta, is a condition characterized by the invasion of the uterine wall by placental tissue. The condition is associated with higher odds of massive post-partum hemorrhage. Several interventions have been developed to improve hemorrhage-related outcomes in these patients; however, there is no evidence to prefer any intervention over another. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an endovascular intervention that may be useful and effective to reduce hemorrhage and transfusions in MAP patients...
2018: World Journal of Emergency Surgery: WJES
Parker Hu, Rindi Uhlich, Frank Gleason, Jeffrey Kerby, Patrick Bosarge
Background: Damage control surgery has revolutionized trauma surgery. Use of damage control surgery allows for resuscitation and reversal of coagulopathy at the risk of loss of abdominal domain and intra-abdominal complications. Temporary abdominal closure is possible with multiple techniques, the choice of which may affect ability to achieve primary fascial closure and further complication. Methods: A retrospective analysis of all trauma patients requiring damage control laparotomy upon admission to an ACS-verified level one trauma center from 2011 to 2016 was performed...
2018: World Journal of Emergency Surgery: WJES
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