Turkish Journal of Trauma & Emergency Surgery : TJTES

BACKGROUND: Ischemia/reperfusion injury is one of the most challenging postoperative situations in vascular surgery, both in elective procedures with prolonged clamping time and in delayed emergency cases with vascular occlusion. The inflammatory response that develops during ischemia and the oxygen-free radicals that proliferate during reperfusion have detrimental effects on the brain, heart, and kidneys. In this study, we aimed to compare the effects of vanillic and rosmarinic acid in preventing ischemia/reperfusion injury in a lower limb ischemia-reperfusion model in rats...

BACKGROUND: The Modified Early Obstetric Warning System (MEOWS) is a score-based or color-coded system that detects changes in physiological parameters and enables earlier diagnosis and care of worsening obstetric patients. The aim of this study is to evaluate the tool's performance and contribute to its use in Türkiye by translating MEOWS into Turkish. METHODS: This prospective and descriptive study, approved by the local ethics committee, included 350 obstetric in-patients who gave birth at Samsun Training and Research Hospital, Gynecology and Children's Hospital between April and August 2022...

We report the case of a 49-year-old woman who suffered an envenomation from a greater weever during a seaside vacation along the Aegean coast in Izmir, Türkiye. Following the incident, she experienced intense pain and sought treatment at an emergency department, where she received analgesics and cold compresses. Unfortunately, this approach failed to alleviate her pain, which persisted for approximately 24 hours. On the twelfth day, with symptoms worsening and the emergence of a larger wound than the one sustained on the day of the incident, she visited the University Hospital for further care, where she received periodic wound cleaning and a six-week antibiotic treatment regimen for possible osteomyelitis after suspicious findings on her Magnetic Resonance Imaging...

BACKGROUND: Gallbladder perforation (GBP) is a rare but life-threatening complication of acute cholecystitis. Despite advancements in imaging technology and biochemical analysis, perforations are still diagnosed intraoperatively in some cases. This situation has revealed the need for new markers in the diagnosis of perforation. In this study, we aimed to analyze the role of biomarkers in the diagnosis of perforated cholecystitis cases. METHODS: In this retrospective study, blood samples (white blood cells (WBC), hemoglobin, platelet count, C-reactive protein (CRP), albumin, CRP/albumin ratio (CAR), neutrophil-lymphocyte ratio (NLR), urea, creatinine, glucose, amylase, lipase, aspartate ami-notransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), total bilirubin, direct bilirubin) were analyzed in patients who were diagnosed with acute cholecystitis in the emergency department...

BACKGROUND: Head trauma is a leading cause of death and disability. While standard treatment protocols exist for severe head trauma, no clear follow-up standards are available for mild head trauma with positive imaging findings in infants and newborns. Although routine follow-up brain computed tomography (CT) imaging is not recommended for children with moderate and mild head trauma, the necessity for follow-up imaging in infants and newborns remains uncertain. METHODS: Our study is a retrospective, observational, and descriptive study...

BACKGROUND: High-energy casualties such as firearm injuries may result in extensive loss of soft tissue and bone in the lower extremities. Although the primary aim in these types of injuries is the preservation of the extremity, repeated surgical procedures for extremity salvage and subsequent restoration of function could have detrimental effects on the patient both physically and psychologically. The main aim of this study is to evaluate the physical and psychological outcomes of patients who underwent lower extremity amputation in the early period after a firearm injury compared with the results of patients who underwent amputation in the late period...

BACKGROUND: Adrenal gland injury (AGI) associated with trauma is an uncommon and often overlooked condition. This study aimed to evaluate the frequency of AGI in individuals with severe trauma injuries and investigate the outcomes of patients with AGI. METHODS: All patients admitted to a tertiary trauma referral center under the trauma protocol who had a computed tomography (CT) scan between January 2012 and January 2023 were analyzed retrospectively. Patients who were dead on arrival and patients with incomplete data were excluded...

BACKGROUND: This study aims to evaluate the accuracy and quality of prehospital assessments and preliminary diagnoses made by Emergency Medical Services (EMS) providers compared to the final diagnoses given by Emergency Department physicians in a metropolitan area. METHODS: This retrospective observational study utilized records from the Yenimahalle EMS Command Center in Ankara, Türkiye, from January 1, 2021, to December 31, 2022. Data were recorded as cases rather than individual patients, with repeated EMS admissions counted separately...

BACKGROUND: Violence at school is broadly defined as a range of acts including physical, psychological, and sexual violence, as well as bullying. These can occur at school, in the school environment, on the way to school, or in any school-related environment. Considering the school environment as the place where a child spends most of their daily life, its impact on the child's life cannot be underestimated. This study aims to contribute to the literature by sharing characteristics of school violence and bullying cases with forensic reports prepared in our department, and by presenting solution suggestions for detecting and preventing these issues...

BACKGROUND: Various factors contribute to the development of mortality and morbidity in hip fracture surgeries. This study aims to investigate the effects of modifiable factors such as the type of anesthesia, anesthesia management, surgical method, and timing of surgery on 30-day mortality rates, intensive care unit admissions, and complications. METHODS: A total of 400 patients who underwent hip fracture surgery between January 2021 and December 2023 at a Training and Research Hospital were retrospectively analyzed...

BACKGROUND: Intimal hyperplasia is a normal adaptive feature of arteries in response to injuries, which include invasive vascular interventions. Its development limits the long-term success of bypass grafts. Various pharmacological agents have been successfully employed in experimental models to reduce the degree of intimal hyperplasia. In our study, we investigated the efficacy of dexamethasone in reducing intimal hyperplasia in rat abdominal aortas after partial transection and primary repair...

BACKGROUND: In earthquakes and other natural disasters, there is a significant number of injuries directly resulting from trauma. Additionally, due to the disaster's impact on overloaded health institutions, healthcare providers face significant challenges during earthquakes. In this context, nearby hospitals providing health services play a crucial role. Nonetheless, with proper planning, the health crisis can be managed in the best possible way. METHODS: A single-center retrospective study was conducted on patients admitted to Mersin City Training and Research Hospital due to injuries attributed to the earthquake that occurred in the southern and mid-eastern regions of Türkiye on February 6, 2023...

BACKGROUND: This study investigated the effects of three different exercise protocols on functional capacity in early-stage burn patients. METHODS: A total of 25 patients hospitalized in the Burn Center (wards and intensive care unit) were included in the study. The individuals were divided into three groups by covariate adaptive randomization according to burn percentage and type: 1 - standard treatment, 2 - standard treatment + aerobic exercise training, 3 - standard treatment + combined exercise (aerobic and resistance) determined by metabolic status...

BACKGROUND: This study explored the potential of non-contrast thoracic computed tomography (CT) to predict anemia by correlating CT parameters with hemoglobin (Hb) levels in patients who underwent non-contrast thoracic CT for various indications. METHODS: This retrospective study included 150 patients who underwent non-contrast thoracic CT scans and complete blood counts within 24 hours at our center between January and June 2023. Exclusion criteria included acute bleeding, iron accumulation disorders, recent transfusions, pregnancy, and certain thoracic CT artifacts...

BACKGROUND: This study aims to discuss the characteristics, origins, degree of injury, results, reporting, and forensic medical aspects of penetrating abdominal injuries. METHODS: In this study, 28,619 cases who applied to the emergency department of Kutahya Health Sciences University Evliya Celebi Training and Research Hospital between January 1, 2016 and December 31, 2020 were reviewed. The forensic reports and medical documents of 85 cases with penetrating abdominal injuries were evaluated retrospectively, with the approval of the ethics committee...

BACKGROUND: The aim of our study is to assess the prognostic impact of the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) on 28-day mortality in patients admitted to the intensive care unit with crush syndrome following the Kahramanmaraş earthquake in Türkiye. METHODS: A total of 63 adult patients with crush syndrome admitted to the intensive care unit after the earthquake were enrolled in this study...

BACKGROUND: This study investigates the effects of hydroxychloroquine (HCQ) on a sepsis-induced acute respiratory distress syndrome (ARDS) model in rats, initiated by a fecal intraperitoneal injection procedure (FIP). METHODS: Three groups were established: control (n=8), FIP + saline (n=7), and FIP + HCQ (20 mg/kg/day) (n=9). Blood samples were collected for arterial blood gas and biochemical analyses, and bilateral pneumonectomy was performed for histopathologic examination...

BACKGROUND: Traumatic liver injury is an acute event that triggers liver repair. The augmenter of liver regeneration (ALR) has been identified as a growth factor involved in this process. This study evaluates the impact of ALR on isolated liver blunt trauma and examines its relationship with various time intervals. METHODS: Forty healthy female Wistar albino rats were divided into five groups (n=8 each). Isolated blunt liver trauma was induced using a custom-designed trauma platform in all groups except for Group 1...

BACKGROUND: Open reduction and internal fixation (ORIF) using locking plates is a widely adopted treatment for displaced proximal humerus fractures. Various augmentation techniques have been developed to enhance the stability of plate fixation. Among these, iliac bone autograft is notable for its advantages over allografts, such as ready availability and the elimination of costs and risks associated with disease transmission. Despite its potential benefits, data on the outcomes of iliac bone autograft augmentation (IBAA) are still limited...

BACKGROUND: Post-ischemia reperfusion can lead to oxidative stress and an increase in oxidative markers. Employing preventive strategies and antioxidant agents may help mitigate ischemia-reperfusion injury (IRI). The use of a tourniquet in extremity surgery has been associated with IRI. This study aims to investigate the impact of three different approaches- brachial plexus block, total intravenous anesthesia (TIVA), and inhalation anesthesia-on IRI during upper extremity surgery using a tourniquet...