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Mori, Alfredo. "Misericord Injuries: Ancient and Modern." Prehospital and Disaster Medicine 34, s1 (May 2019): s150. http://dx.doi.org/10.1017/s1049023x19003364.
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Introduction:The Misericord, or stabbing pike, was a frequently used battlefield implement in medieval times. The misericord was used by battlefield clerics to relieve the suffering of irreparably wounded soldiers. Its cultural parallels include the Roman gladius, the Japanese wakazashi, and the eponymous Liston knife used in pre-Victorian era surgery in England.Methods:This demonstration will analyze modern misericord injuries in the light of the current epidemic of long knife (or zombie knife) attacks in London and the domestic terrorist threat in Australia.Discussion:A review of this weapon is pertinent to the projected low-technology, low-impact, and deep-penetrating wounds expected in urban terrorism in Australia and other cities globally. The talk will emphasize field discussion, demonstration, and disarming techniques against modern misericord-type weapons.
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Sampson, Amanda K., Behrooz Hassani-Mahmooei, and Alex Collie. "Lack of English proficiency is associated with the characteristics of work- related injury and recovery cost in the Victorian working population." Work 67, no. 3 (December 1, 2020): 741–52. http://dx.doi.org/10.3233/wor-203323.
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BACKGROUND: Migrant workers have been identified in Europe, North America, Asia and Australia as a particularly vulnerable working population with a higher risk of work-related injury and mortality compared to non-migrant workers. Lack of English language proficiency is associated with an increased risk of work-related injury. Whether lack of English proficiency influences post-injury recovery or return to work outcomes remains unknown. OBJECTIVE: Using administrative data from a population based workers’ compensation dataset in the state of Victoria, Australia, we aimed to examine work-related injury rates, worker characteristics and compensation outcomes in workers who were not proficient in English. We hypothesized that the use of an interpreter service would be associated with a poorer post-injury recovery profile and worse return to work outcomes. METHODS: WorkSafe Victoria accepted non-fatal claims for injuries and illnesses reported between January 1, 2003, and December 31, 2012 by workers aged 15 to 74 (n = 402, 828 claims) were analysed. Consistent with prior research, we selected “use of an interpreter service” as the indicator of English language proficiency. The total and categorical compensable cost of recovery was used as recovery outcomes. RESULTS: Of these claims, 16,286 (4%) involved the use of an interpreter service (LOTE workers). Our analysis revealed that Victorian injured LOTE workers have significantly different demographic, occupational and injury characteristics compared to non-LOTE injured workers. Furthermore, we present novel evidence that LOTE status was associated with poorer long-term injury outcomes, observed as a greater healthcare utilisation and larger paid income benefits, after controlling for occupation, employment status and injury type compared to non-LOTE injured workers. CONCLUSIONS: These data suggest that English language proficiency is associated not only with the risk of work-related injury but also to the long-term recovery outcomes. We conclude that despite access to language interpreter services, injured LOTE workers experience English language proficiency dependent, and injury severity independent, recovery barriers which need to be overcome to improve long term recovery outcomes.
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Lamb, Katie, Kirsty Forsdike, Cathy Humphreys, and Kelsey Hegarty. "Drawing upon the evidence to develop a multiagency risk assessment and risk management framework for domestic violence." Journal of Gender-Based Violence 6, no. 1 (February 1, 2022): 173–208. http://dx.doi.org/10.1332/239868021x16366281022699.
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Domestic violence poses a threat to the health, safety and wellbeing of women internationally and is associated with a range of physical injuries, chronic mental and physical health issues and death. In recognition of the serious consequences and to guide the allocation of resources, multiple countries have invested in efforts to measure domestic violence risk. This study aimed to determine whether there was an existing validated risk assessment tool with an actuarial element, or a common set of evidence-based risk factors that could be implemented in Victoria, Australia. A tool was sought which would effectively predict risk of severity, lethality and re-assault and support risk management strategies. The tool needed to be suitable for administration by a variety of professionals. Through an audit and analysis of existing tools, the study found an absence of universal standards or guidance for weighting actuarial tools and clear insight into how risk assessments currently inform risk management practice and multidisciplinary responses. However, the literature provides clarity around the key evidence-based risk factors that most commonly form a validated tool for adult victim survivors. The evidence was less definitive in terms of assessing risk of lethality and re-assault for children and young people.
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Lee, A. J., I. E. Gibb, and T. Stevenson. "How has military use of medical imaging in austere environments changed? A comparison between deployments of the Victorian era and today." Journal of The Royal Naval Medical Service 104, no. 2 (2018): 139–47. http://dx.doi.org/10.1136/jrnms-104-139.
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AbstractOver 100 years ago, in the late 19th century, the British military first deployed radiological equipment to theatres of war, notably to Afghanistan during the Tirah campaign and to Sudan during the River War. The efforts of early radiological pioneers, and the clear diagnostic utility their equipment offered, quickly saw radiology formally incorporated into military medicine as its own discipline. The two World Wars saw the specialisation advance rapidly in scope and capability. To draw comparison with earlier conflicts, the early 21st century saw modern medical imaging equipment utilised in the same geographical regions: first as part of Op HERRICK in Afghanistan from 2003-14; and currently as part of Op TRENTON in South Sudan.In the intervening period throughout the 20th century, the capability has developed enormously. Initially the ‘Roentgen Ray’, X-ray was used to identify bone fractures and locate and identify foreign bodies located within wounds, thus reducing the risk of infection and further trauma previously inflicted by surgical exploration, whilst also giving added precision to extraction of bullets and fragmentation. Modern day military radiology further improves diagnostic capability, giving a more comprehensive picture of injuries sustained and providing assistance in treatment. State-of-the-art radiological equipment can now be routinely operated in the most austere military environments. Nonetheless, modern military radiologists face similar challenges to their Victorian counterparts in delivering capability, notably climate, equipment fragility and environmental hazards. Whilst equipment continues to evolve, the need for resourcefulness and adaptability amongst those personnel operating and maintaining it remains undiminished.
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Peiris, Sujanie, Stuart Newstead, Janneke Berecki-Gisolf, Bernard Chen, and Brian Fildes. "Quantifying the Lost Safety Benefits of ADAS Technologies Due to Inadequate Supporting Road Infrastructure." Sustainability 14, no. 4 (February 16, 2022): 2234. http://dx.doi.org/10.3390/su14042234.
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Advanced driver assistance systems (ADAS) provide warnings to drivers and, if applicable, intervene to mitigate a collision if one is imminent. Autonomous emergency brakes (AEB) and lane keep assistance (LKA) systems are mandated in several new vehicles, given their predicted injury and fatality reduction benefits. These predicted benefits are based on the assumption that roads are always entirely supportive of ADAS technologies. Little research, however, has been conducted regarding the preparedness of the road network to support these technologies in Australia, given its vastly expansive terrain and varying road quality. The objective of this study was to estimate what proportion of crashes that are sensitive to AEB and LKA, would not be mitigated due to unsupportive road infrastructure, and therefore, the lost benefits of the technologies due to inadequate road infrastructure. To do this, previously identified technology effectiveness estimates and a published methodology for identifying ADAS-supportive infrastructure availability was applied to an estimated AEB and LKA-sensitive crash subset (using crash data from Victoria, South Australia and Queensland, 2013–2018 inclusive). Findings demonstrate that while the road networks across the three states appeared largely supportive of AEB technology, the lack of delineation across arterial and sub-arterial (or equivalent) roads is likely to have serious implications on road safety, given 13–23% of all fatal and serious injury (FSI) crashes that occurred on these road classes were LKA-sensitive. Based on historical crash data, over 37 fatalities and 357 serious injuries may not be avoided annually across the three Australian states based on the lack of satisfactory road delineation on arterial and sub-arterial (or equivalent) roads alone. Further, almost 24% of fatalities in Victoria, 24% of fatalities in Queensland and 21% of fatalities in South Australia (that are AEB- or LKA-sensitive) are unlikely to be prevented, given existing road infrastructure. These figures are conservative estimates of the lost benefits of the technologies as they only consider fatal and serious injury crashes and do not include minor injury or property damage crashes, the benefits of pedestrian-sensitive AEB crashes in high-speed zones or AEB fitted to heavy vehicles. It is timely for road investments to be considered, prioritised and allocated, given the anticipated penetration of the new technologies into the fleet, to ensure that the road infrastructure is capable of supporting the upcoming fleet safety improvements.
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Peiris, Sujanie, Stuart Newstead, Janneke Berecki-Gisolf, and Brian Fildes. "Quantifying the Foregone Benefits of Intelligent Speed Assist Due to the Limited Availability of Speed Signs across Three Australian States." Sensors 22, no. 20 (October 13, 2022): 7765. http://dx.doi.org/10.3390/s22207765.
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By being able to communicate the speed limit to drivers using speed sign recognition cameras, Intelligent Speed Assist (ISA) is expected to bring significant road safety gains through increased speed compliance. In the absence of complete digital speed maps and due to limited cellular connectivity throughout Australia, this study estimated the forgone savings of ISA in the event that speed signs are solely relied upon for optimal advisory ISA function. First, speed-related fatalities and serious injuries (FSI) in the Australian states of Victoria, South Australia, and Queensland (2013–2018) were identified, and published effectiveness estimates of ISA were applied to determine the potential benefits of ISA. Subsequently, taking into account speed sign presence across the three states, the forgone savings of ISA were estimated as FSI that would not be prevented due to absent speed signage. Annually, 27–35% of speed-related FSI in each state are unlikely to be prevented by ISA because speed sign infrastructure is absent, equating to economic losses of between AUD 62 and 153 million. Despite a number of assumptions being made regarding ISA fitment and driver acceptance of the technology, conservative estimates suggest that the benefits of speed signs placed consistently across road classes and remoteness levels would far outweigh the costs expected from the absence of speed signs. The development and utilisation of a methodology for estimating the foregone benefits of ISA due to suboptimal road infrastructure constitutes a novel contribution to research. This work provides a means of identifying where infrastructure investments should be targeted to capitalise on benefits offered by advanced driver assist technologies.
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Chen, Amy Y., Michael G. Stewart, and Glenn Raup. "Penetrating Injuries of the Face." Otolaryngology–Head and Neck Surgery 115, no. 5 (November 1996): 464–70. http://dx.doi.org/10.1177/019459989611500519.
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We reviewed 78 consecutive cases of penetrating facial injuries treated at Ben Taub General Hospital in Houston, Texas, between 1992 and 1994, and we analyzed injury patterns on the basis of (1) the mechanism of injury, and (2) the entry zone of the wounds. We found that gunshot wounds were more likely to require emergent airway establishment than shotgun wounds or stab wounds ( p = 0.03). We noted a higher prevalence of globe injury among shotgun wounds than among gunshot wounds ( p = 0.02). Nine (12%) patients had intracranial penetration of a bullet or shotgun pellet. Patients with gunshot wounds required open reduction and internal fixation of facial bone fractures more frequently than patients with shotgun wounds ( p = 0.01). Thirty patients underwent arteriograms, and 10 demonstrated positive findings. Although there were only 3 deaths in our series, 29 (37%) patients overall had some complication caused by their penetrating facial trauma, including blindness in 12 patients. There was no significant difference in the prevalence of complications between gunshot, shotgun, and stab wounds ( p = 0.18). With these injury patterns in mind, we describe an algorithm for evaluation and management of penetrating injuries of the face.
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Maslyakov, VV, EV Krjukov, VG Barsukov, KG Kurkin, PA Dorzhiev, and VR Gorbelik. "Heart injuries: main clinical symptoms." Laboratory diagnostics, no. 1 (February 27, 2019): 53–56. http://dx.doi.org/10.24075/brsmu.2019.003.
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Injuries to the heart are uncommon in peacetime, yet they result in life-threatening conditions, which makes timely diagnostics a crucial factor in saving patients' lives. In this connection, it is important to define the main signs of heart injuries. This study aimed to analyze the basic clinical symptoms associated with various wounds to the heart. We have retrospectively analyzed such symptoms registered in 86 patients with varying chest injuries that affect the heart. All patients were treated in the emergency surgery unit of the Engels Town Hospital from 1991 to 2017. 41 (47.6%) patient had stab wounds, and there were 45 (52.3%) cases of gunshot wounds. 23 (26.7%) patients had chest injuries affecting heart exclusively, while for 63 (73.2%) the consequences were wounds to other organs. We found that the clinical picture depends on the kind of injury to the heart: stab and slash wounds translate into more pronounced symptoms, while gunshot wounds do not produce such an effect. Accepting patients, practitioners should take this fact into account. The misdiagnosis rate for stab and slash heart wounds is 9.7%, that for gunshot wounds — 17.7%, the latter being the result of vagueness of the clinical picture. The clinical signs are most pronounced in the cases of stab and slash wounds to the heart.
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Fong, Lye Pheng, and Lye Pheng Fong. "Eye injuries in Victoria, Australia." Medical Journal of Australia 162, no. 2 (January 1995): 64–68. http://dx.doi.org/10.5694/j.1326-5377.1995.tb138434.x.
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Maurin, Olga, Stanislas de Régloix, Stéphane Dubourdieu, Hugues Lefort, Stéphane Boizat, Benoit Houze, Jennifer Culoma, Guillaume Burlaton, and Jean-Pierre Tourtier. "Maxillofacial Gunshot Wounds." Prehospital and Disaster Medicine 30, no. 3 (April 14, 2015): 316–19. http://dx.doi.org/10.1017/s1049023x1500463x.
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AbstractThe majority of maxillofacial gunshot wounds are caused by suicide attempts. Young men are affected most often. When the lower one-third of the face is involved, airway patency (1.6% of the cases) and hemorrhage control (1.9% of the cases) are the two most urgent complications to monitor and prevent. Spinal fractures are observed with 10% of maxillary injuries and in 20% of orbital injuries. Actions to treat the facial gunshot victim need to be performed, keeping in mind spine immobilization until radiographic imaging is complete and any required spinal stabilization accomplished. Patients should be transported to a trauma center equipped to deal with maxillofacial and neurosurgery because 40% require emergency surgery. The mortality rate of maxillofacial injuries shortly after arrival at a hospital varies from 2.8% to 11.0%. Complications such as hemiparesis or cranial nerve paralysis occur in 20% of survivors. This case has been reported on a victim of four gunshot injuries. One of the gunshots was to the left mandibular ramus and became lodged in the C4 vertebral bone.MaurinO, de RégloixS, DubourdieuS, LefortH, BoizatS, HouzeB, CulomaJ, BurlatonG, TourtierJP. Maxillofacial gunshot wounds. Prehosp Disaster Med. 2015;30(3):14.
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Elbardesy, Hany, Eoghan Meagher, and Shane Guerin. "Impact of the COVID-19 pandemic on the trauma and orthopaedic department at level one Major Trauma Centre in the republic of Ireland." Acta Orthopaedica Belgica 87, no. 3 (September 30, 2021): 571–78. http://dx.doi.org/10.52628/87.3.26.
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The Coronavirus Disease (COVID-19) has been identified as the cause of a rapidly spreading respira- tory illness in Wuhan, Hubei Province, China in early December 2019. Since then, the free movement of people has decreased. The trauma-related injuries and the demand on the trauma and orthopaedic service would be expected to fall. The aim of this study to examine the impact of the COVID-19 pandemic on a level 1 Trauma Centre in the Republic of Ireland (ROI). Patients admitted to the Trauma & Orthopaedic (T&O) Department at Cork University Hospital (CUH) and the South Infirmary Victoria University Hospital (SIVUH), and their associated fracture patterns and management, between 01/03/20 and the 15/04/20 were documented and compared to the patient admissions from the same time period one year earlier in 2019. The total number of T&O operations performed decreased by 10.15% (P= 0.03)between the two time periods. The number of paediatric procedures fell by 40.32% (P= 0.15). Adult Distal radius and paediatric elbow fractures (excluding supracondylar fracture) increased by 88% and 13% (P= 0.19), (P= 0.04) respectively. Hip fractures remained the most common fracture-type admitted for surgery. The COVID-19 crisis has to lead to a decrease in the total numbers of trauma surgeries in a major trauma centre in the ROI. This decline is most evident in the number of paediatric and male adult patients presenting with fractures requiring operative management. Interestingly, fractures directly related to solo outdoor activities, such as running or cycling, as well as simple mechanical falls like ankle, distal radius, elbow, and hand fractures all increased. Irish males were more compliant with outdoors restrictions than females.
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de Rooster, H., O. Taeymans, H. van Bree, and M. Risselada. "Penetrating injuries in dogs and cats." Veterinary and Comparative Orthopaedics and Traumatology 21, no. 05 (2008): 434–39. http://dx.doi.org/10.3415/vcot-07-02-0019.
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SummaryThe objective of this retrospective study was to assess radiographical and surgical findings, surgical management and outcome of penetrating injuries in dogs and cats by evaluating patient records. Sixteen patients were identified (15 dogs and one cat), four with gunshot wounds, and 12 with fight wounds (11 with bite wounds, one struck by a claw). The thoracic cavity was affected in six patients, the abdominal cavity in three cases. Both cavities were affected in five dogs and the trachea in two cases. All of the patients with fight wounds were small breed dogs. Multiple injuries to internal organs that required intervention were found surgically after gunshot wounds and a high amount of soft tissue trauma requiring reconstruction was present after fight wounds. Radiography diagnosed body wall disruption in two cases. All of the affected thoracic body walls in the fight group had intercostal muscle disruptions which was diagnosed surgically. Fourteen patients survived until discharge and had a good outcome. In conclusion, penetrating injuries should be explored as they are usually accompanied by severe damage to either the internal organs or to the body wall. A high level of awareness is required to properly determine the degree of trauma of intercostal muscle disruption in thoracic fight wounds.
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Raymond, Simon, Ian Favilla, Anh Nguyen, Mark Jenkins, and Greg Mason. "Eye injuries in rural Victoria, Australia." Clinical & Experimental Ophthalmology 37, no. 7 (September 2009): 698–702. http://dx.doi.org/10.1111/j.1442-9071.2009.02110.x.
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Routley, Virginia. "Air transport-related injuries – Victoria, Australia." Injury Control and Safety Promotion 9, no. 1 (March 2002): 61–63. http://dx.doi.org/10.1076/icsp.9.1.61.3322.
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Mittal, Vijay, Paul Mcaleese, Shun Young, and Max Cohen. "Penetrating Cardiac Injuries." American Surgeon 65, no. 5 (May 1999): 444–48. http://dx.doi.org/10.1177/000313489906500513.
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Our objective was to determine the influence of several clinical factors on the survival of patients with penetrating wounds to the heart. A retrospective review of 80 consecutive penetrating cardiac injuries treated in a Level II urban trauma center from 1980 through 1994 were examined. Thirty-six patients (45%) had gunshot wounds (including 1 shotgun wound), and 44 (55%) had stab wounds. Intervention consisted of emergency room (ER) or operating room thoracotomy. We measured the effect of several clinical factors on morbidity and patient survival. Survival rate was 17 of 36 (47%) in gunshot injuries and 35 of 44 (80%) in stab injuries, with an overall survival rate of 52 of 80 patients (65%). The average age was 24 years (range, 9–53), and there were 3 female patients. Twelve patients (15%) had multiple cardiac injuries, and 63 (79%) had other associated injuries. Fourteen patients (17%) presented with no blood pressure, and 55 (69%) were hypotensive on admission. ER thoracotomy was performed on 7 of 52 survivors (13%) and 24 of 28 nonsurvivors (86%). Survival after ER thoracotomy was 7 of 31 patients (22%). A selective approach is recommended, because ER thoracotomy has a limited role in penetrating cardiac injury. A high index of suspicion, prompt resuscitation, and immediate definitive surgical management resulted in a high survival rate for these frequently lethal injuries.
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Spalding, T. J. W., M. P. M. Stewart, D. N. Tulloch, and K. M. Stephens. "Penetrating missile injuries in the Gulf War 1991." Journal of The Royal Naval Medical Service 78, no. 2 (June 1992): 73–77. http://dx.doi.org/10.1136/jrnms-78-73.
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AbstractDuring the Gulf War in 1991 63 patients (including 29 Iraqi prisoners of war) with penetrating missile injuries underwent surgery in a British Army Field Hospital. Their injuries and initial operative management are reported.Fifty-one casualties (81%) suffered an average of nine wounds (range 1–45) due to fragmentation weapons, and 12 casualties sustained bullet wounds. All wounds were explored following the established principles of war surgery. The extremities were involved in 48 patients (76%). Eight compound long bone fractures were managed with external skeletal fixators applied at the time of initial surgery. Laparotomy was performed on seven patients, one of whom died. The average duration of surgery was 77 minutes for fragment wounds and 85 minutes for bullet wounds.
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Almarzooei, Khamis. "Pedal cycle injuries and mortality in Victoria." Pathology 49 (February 2017): S21. http://dx.doi.org/10.1016/j.pathol.2016.12.044.
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Danyliuk, Mykhailo, Vitalii Zozulia, V. Siukaiev, Oleksandr Ghanskiy, and Volodymyr Lesyk. "SUICIDE WITH SIMULATED GUNSHOT WOUNDS." Forensic-medical examination, no. 2 (November 20, 2015): 124–30. http://dx.doi.org/10.24061/2707-8728.2.2015.19.
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Given a case of suicide using a device for slaughtering cattle, limitirovanie gunshot damage to the skull. Despite versent the many facets of the problem of firearm injuries, its execution is judicial-medical examination continuesto be one of the most difficult.An integrated approach to the examination of gunshot injuries to the additional medical and forensic studies and a series of experimental shots is optimal for the objective of addressing issues relating to distance from which the shot was made.
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Bingol, Hakan. "Abdominal Vascular Injuries Due to Missile Wounds." Journal of Academic Research in Medicine 4, no. 1 (May 2, 2014): 25–27. http://dx.doi.org/10.5152/jarem.2013.03.
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Leppäniemi, Ari, and Reijo Haapiainen. "Occult Diaphragmatic Injuries Caused by Stab Wounds." Journal of Trauma: Injury, Infection, and Critical Care 55, no. 4 (October 2003): 646–50. http://dx.doi.org/10.1097/01.ta.0000092592.63261.7e.
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Richards, John T., Archie Overmann, Jonathan A. Forsberg, and Benjamin K. Potter. "Complications of Combat Blast Injuries and Wounds." Current Trauma Reports 4, no. 4 (August 18, 2018): 348–58. http://dx.doi.org/10.1007/s40719-018-0143-1.
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Madsen, AS, GL Laing, JL Bruce, and DL Clarke. "A comparative audit of gunshot wounds and stab wounds to the neck in a South African metropolitan trauma service." Annals of The Royal College of Surgeons of England 98, no. 7 (September 2016): 488–95. http://dx.doi.org/10.1308/rcsann.2016.0181.
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Introduction The aim of this comparative study of gunshot wounds (GSWs) and stab wounds (SWs) to the neck was to quantify the impact of the mechanism of injury on the outcome and management of penetrating neck injury (PNI). Methods A prospective trauma registry was interrogated retrospectively. Data were analysed pertaining to demographics and injury severity score (ISS), physiology on presentation, anatomical site of wounds and injuries sustained, investigations, management, outcome and complications. Results There were 452 SW and 58 GSW cases over the 46 months of the study. Patients with GSWs were more likely to have extracervical injuries than those with SWs (69% vs 63%). The incidence of a ‘significant cervical injury’ was almost twice as high in the GSW cohort (55% vs 31%). For patients with transcervical GSWs, this increased to 80%. The mean ISS was 17 for GSW and 11 for SW patients. Those in the GSW cohort presented with threatened airways and a requirement for an emergency airway three times as often as patients with SWs (24% vs 7% and 14% vs 5% respectively). The incidence among GSW and SW patients respectively was 5% and 6% for airway injuries, 12% and 8% for injuries to the digestive tract, 21% and 16% for vascular injuries, 59% and 10% for associated cervical injuries, 36% and 14% for maxillofacial injuries, 16% and 9% for injuries to the head, and 35% and 45% for injuries to the chest. In the GSW group, 91% underwent computed tomography angiography (CTA), with 23% of these being positive for a vascular injury. For SWs, 74% of patients underwent CTA, with 17% positive for a vascular injury. Slightly more patients with GSWs required operative intervention than those with SWs (29% vs 26%). Conclusions Patients with GSWs to the neck have a worse outcome than those with injuries secondary to SWs. However, the proportion of neck injuries actually requiring direct surgical intervention is not increased and most cases with PNI secondary to GSWs can be managed conservatively with a good outcome. Imaging should be performed for all GSWs to the neck.
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Djuraev, Jamolbek A. "RADIOLOGICAL EXAMINATION OF FACE-JAW JOINT WOUNDS." Oriental Journal of Medicine and Pharmacology 02, no. 01 (March 1, 2022): 153–67. http://dx.doi.org/10.37547/supsci-ojmp-02-01-12.
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The reason for the interest in the problem of facial and maxillofacial injuries (CJS) is the increase in the number of injuries to the tissue structures of the face and brain, which is characterized by uncertainty of consequences and difficulty of treatment outcome. Occurrence of neurological deficits in the post-injury period disrupts patients’ social adjustment. The serious consequences of acute joint facial injuries make it one of the social problems of national and global importance.
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Kvasnevskyi, Yevhen, Michailo Kashtalian, Oleh Gerasimenko, and Oleksandr Kvasnevskyi. "Experimental Study of Action Different Kinetic Energy on the Colon." Lietuvos chirurgija 21, no. 2 (May 2, 2022): 105–8. http://dx.doi.org/10.15388/lietchirur.2022.21.61.
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The purpose of the study. To increase the effectiveness of surgical care for the wounded with combat trauma of the colon by studying of ballistic, morphological and functional features of the gunshot wounds. Patients and methods. A study of surgical treatment of 83 wounded with combat injuries of the colon, received in the area of anti-terrorist operation in the period from 2014–2018. For comparative analysis of treatment results, two clinical groups were formed: comparison and main. The comparison group included 42 wounded who were treated from April 2014 to February 2015 (the first and second periods of ATO), who used traditional surgical tactics. The main group included 41 wounded who were treated from March 2015 to 2018. Results. Analysis of the distribution of wounded with combat trauma by type of wound / injury revealed that the vast majority of them in both groups had shrapnel wounds – 49 (59.1%). There were 30 (36.1%) victims with bullet wounds, and 4 (4.8%) with closed injuries. The wounded patients with the battle trauma of the thick bowel by type of injury had missile wounds as a rule – 49 (59.1%). There were 30 (36.1%) patients with bullet wounds, and 4 (4.8%) with closed injuries. Most of the injuries were combined – 58 (69.9%), and with only abdominal injuries – 25 (30.1%), mostly multiple – 21 (25.3%). The great majority of the thick bowel injuries belonged to sigmoid – 32 (38.6%) and transverse colon – 21 (25.3%), which is explained by relatively large size of these parts of the intestine. Conclusions. The choice of surgical tactics and scope of surgical interventions on damaged organs and structures took into account the results of experimental study of mechanogenesis and pathomorphology of gunshot wounds of the colon, obtained in bench studies by modeling gunshot wounds on “thoracoabdominal ballistic material”.
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Bradic, Nikola, Drazen Cuculic, and Ervin Jancic. "Terrorism in Croatia." Prehospital and Disaster Medicine 18, no. 2 (June 2003): 88–91. http://dx.doi.org/10.1017/s1049023x00000819.
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AbstractIntroduction:This report illustrates Croatia's experience with the terrorist attack in the city of Rijeka in October 1995. Also, the intention of this report is to outline how emergency services were functioning in this sudden-onset situation.Methods:The medical documentation of 27 wounded citizens in the attack was analyzed and the appearance of bodily wounds, severity of wounds, and the mechanisms of injury are described. From the forensic medical report, the wounds and damages sustained by the terrorist also were analyzed. All findings were compared with similar cases from around the world.Results:In the 27 wounded citizens, three (11%) had head injuries, and injuries of the abdomen in only two cases (7%) were found. The most common injuries sustained involved one or more extremities: 16 (59%) persons had wounds of an upper or lower extremity or a combination of multiple wounds. The main cause of death of the terrorist was explosive wounds to the chest and abdomen with destruction of multiple inner organs (primarily kidneys, liver, abdomen, and lung). Furthermore, the terrorist had a fracture of the skull base and multiple injuries to the brain.Conclusion:Comparing the findings with other data from the literature, the distribution in the percentages of wounded is almost the same as reported in many bomb attacks. In this case, the walls of the building protected many citizens, which is why so few were seriously injured. Forensic examination of the terrorist's body showed all of the characteristics of blast injuries.
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Kennedy, Victoria, and Paul Aldridge. "Acute oropharyngeal puncture wounds: a review." Companion Animal 27, no. 4 (April 2, 2022): 1–7. http://dx.doi.org/10.12968/coan.2021.0086.
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Oropharyngeal injuries are commonly seen in practice. Severity can range from minor to life threatening in the case of dorsal pharyngeal or oesophageal punctures. A prompt diagnosis and early aggressive surgical management may be required to prevent the development of mediastinitis and sepsis. This article will look at acute injuries and outline a systematic approach to these cases, enabling the clinician to make early decisions rather than adopting a ‘wait and see’ approach.
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Yamamoto, Ryo, Mark Muir, and Alicia Logue. "Colon Trauma: Evidence-Based Practices." Clinics in Colon and Rectal Surgery 31, no. 01 (December 19, 2017): 011–16. http://dx.doi.org/10.1055/s-0037-1602175.
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AbstractColon injury is not uncommon and occurs in about a half of patients with penetrating hollow viscus injuries. Despite major advances in the operative management of penetrating colon wounds, there remains discussion regarding the appropriate treatment of destructive colon injuries, with a significant amount of scientific evidence supporting segmental resection with primary anastomosis in most patients without comorbidities or large transfusion requirement. Although literature is sparse concerning the management of blunt colon injuries, some studies have shown operative decision based on an algorithm originally defined for penetrating wounds should be considered in blunt colon injuries. The optimal management of colonic injuries in patients requiring damage control surgery (DCS) also remains controversial. Studies have recently reported that there is no increased risk compared with patients treated without DCS if fascial closure is completed on the first reoperation, or that a management algorithm for penetrating colon wounds is probably efficacious for colon injuries in the setting of DCS as well.
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Loskutov, Aleksandr, Andriy Domanskyi, Ivan Zherdev, and Svyatoslav Lushnya. "Features of medical care in patientswith elbow joint gunshot wounds." ORTHOPAEDICS, TRAUMATOLOGY and PROSTHETICS, no. 1 (October 5, 2021): 5–8. http://dx.doi.org/10.15674/0030-5987202115-8.
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Gunshot wounds of the elbow joint are the third most common after knee and shoulder injuries. Features of the anatomical and functional structure of the elbow joint, the close location of the vascular and nervous formations, favorable conditions for the development of infection determine the severity of gunshot wounds and cause the complexity of its treatment. Objective. To evaluate the frequency and nature of the elbow joint gunshot wounds in the structure of the general combat injuries, as well as to determine the volume of medical care and direction of treatment of such injuries in the conditions of the regional hospital as a stage of care. Methods. A retrospective study included 1 809 patients (96.0 % of men, mean age (33.7 ± 0.2) years). Firearms limb injuries were detected in 1 013 (56.0 %) of all victims, of which the elbow joint — 25 (2.47 %). Mines and explosives injuries were in 22 (88 %) of the patients, bullet — in 3 (12 %). Results. Tactics of treatment of elbow joint gunshot wounds depended on the severity of the condition of the victims and the nature of concomitant traumatic injuries. In the structure of combat injury of the elbow joint the majority was combined (52 %) and multiple (40 %) injuries and was accompanied by gunshot fractures in 60 %. In patients who were in severe state, applied the tactics of Damage control in two stages. At the first stage the fractures were fixed with plaster splints or external fixation devices (EF), the wounds were not subjected to full surgical debridment (SD), but only washed with antiseptics and the visible foreign bodies were removed. In patients with soft tissue injuries wounds the primary SD was performed according to general principles, injured nerves were not restored. In the second stage, after patient is stabilized, the repeated SD of the wound was performed. After their uncomplicated healing the EF was removed and the method of fixation was changed to internal osteosyntesis. Conclusions. It is recommended to perform stabilization of intra-articular gunshot fractures of the elbow joint with EF and after uncomplicated wound healing go to the internal osteosynthesis. Key words. Elbow joint, gunshot wounds, treatment.
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Oosthuizen, GV, VY Kong, T. Estherhuizen, JL Bruce, GL Laing, JJ Odendaal, and DL Clarke. "The impact of mechanism on the management and outcome of penetrating colonic trauma." Annals of The Royal College of Surgeons of England 100, no. 2 (February 2018): 152–56. http://dx.doi.org/10.1308/rcsann.2017.0147.
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Introduction In light of continuing controversy surrounding the management of penetrating colonic injuries, we set out to compare the outcome of penetrating colonic trauma according to whether the mechanism of injury was a stab wound or a gunshot wound. Methods Our trauma registry was interrogated for the 5-year period from January 2012 to December 2016. All patients over the age of 18 years with penetrating trauma (stab or gunshot) and with intraoperatively proven colonic injury were reviewed. Details of the colonic and concurrent abdominal injuries were recorded, together with the operative management strategy. In-hospital morbidities were divided into colon-related and non-colon related morbidities. The length of hospital stay and mortality were recorded. Direct comparison was made between patients with stab wounds and gunshot wounds to the colon. Results During the 5-year study period, 257 patients sustained a colonic injury secondary to penetrating trauma; 95% (244/257) were male and the mean age was 30 years. A total of 113 (44%) sustained a gunshot wound and the remaining 56% (144/257) sustained a stab wound. Some 88% (226/257) of all patients sustained a single colonic injury, while 12% (31/257) sustained more than one colonic injury. A total of 294 colonic injuries were found at laparotomy. Multiple colonic injuries were less commonly encountered in stab wounds (6%, 9/144 vs. 19%, 22/113, P < 0.001). Primary repair was more commonly performed for stab wounds compared with gunshot wounds (118/144 vs. 59/113, P < 0.001). Patients with gunshot wounds were more likely to need admission to intensive care, more likely to experience anastomotic failure, and had higher mortality. Conclusions It would appear that colonic stab wounds and colonic gunshot wounds are different in terms of severity of the injury and in terms of outcome. While primary repair is almost always applicable to the management of colonic stab wounds, the same cannot be said for colonic gunshot wounds. The management of colonic gunshot wounds should be examined separately from that of stab wounds.
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Shabhay, Ahmed, Zarina Shabhay, Kondo Chilonga, Theresia Mwakyembe, David Msuya, Fabian Massaga, and Samwel Chugulu. "Potential Spectrum of Accompanied Penetrating Abdominal Intraperitoneal Injuries with Bowel Evisceration: Surprises Awaiting the Trauma Surgeon in Resource Limited Settings." Case Reports in Surgery 2022 (October 25, 2022): 1–7. http://dx.doi.org/10.1155/2022/8015067.
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Penetrating abdominal injuries involves violation of the peritoneal cavity and injuries to solid organs and other intraperitoneal viscera such as major blood vessels and hollow organs. Typically such injuries arise from gunshot wounds or stab wounds. With increase in crime rates and motor traffic accidents in urban areas, the trauma surgeon in civilian urban centers faces spectrum of injuries similar to his colleague in war torn areas. Potential spectrum of penetrating abdominal injuries is wide and accurate diagnosis in resource limited centers is challenging. Majority of injuries are concealed and diagnosed intraoperatively and dealt with relatively junior trauma surgeons in emergency settings in remote limited settings. Computed tomography (CT) scans and Magnetic Resonance Imaging (MRI) facilities are scarce in resource limited settings. Haemodynamic states of penetrating abdominal injuries patients presenting in emergency departments necessitate urgent surgical exploration and management with minimal room for full radiological work-up. Evisceration of bowels with unstable haemodynamic states mandate laparotomy due to wide spectrum of accompanied intraperitoneal injuries. Four cases of penetrating abdominal injuries are presented with modes of assault ranging from gunshot injuries to stab wounds with broken bottles to highlight the intra-abdominal spectrum of injuries, challenges in diagnosis and emergency managements done in a resource limited setting.
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Sikic, Mirjana, Antonina A. Mikocka‐Walus, Belinda J. Gabbe, Francis T. McDermott, and Peter A. Cameron. "Bicycling injuries and mortality in Victoria, 2001–2006." Medical Journal of Australia 190, no. 7 (April 2009): 353–56. http://dx.doi.org/10.5694/j.1326-5377.2009.tb02446.x.
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Wardlaw, Malcolm J. "Bicycling injuries and mortality in Victoria, 2001–2006." Medical Journal of Australia 191, no. 5 (September 2009): 295–96. http://dx.doi.org/10.5694/j.1326-5377.2009.tb02802.x.
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Mikocka‐Walus, Antonina A., Francis T. McDermott, and Peter A. Cameron. "Bicycling injuries and mortality in Victoria, 2001–2006." Medical Journal of Australia 191, no. 5 (September 2009): 295–96. http://dx.doi.org/10.5694/j.1326-5377.2009.tb02803.x.
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Makhadi, Shumani, Maeyane Stephens Moeng, Chikwendu Ede, Farhana Jassat, and Sechaba Thabo Palweni. "Penetrating Cardiac Injuries: Outcome of Treatment from a Level 1 Trauma Centre in South Africa." Trauma Care 2, no. 2 (May 2, 2022): 251–59. http://dx.doi.org/10.3390/traumacare2020021.
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Background: Penetrating cardiac injuries are rare in South African and international literature. Penetrating cardiac injuries are regarded as one of the most lethal injuries in trauma patients. The mechanism of injury varies across the world. In developing countries, stab wounds cause the majority of penetrating cardiac injuries. These injuries remain clinically challenging and are associated with high mortalities. Aim: To describe our experience with penetrating cardiac injuries and the outcome of their management at a level 1 trauma unit in Johannesburg, South Africa. Materials and methods: We retrospectively reviewed all patients who presented with penetrating cardiac injuries over a period of four years (1 January 2016 to 31 December 2019). The patients were identified using the hospital database. The patient’s demographics, mechanism of injury, injury severity score, vital signs, investigation findings, final diagnosis, type of operation, length of hospital stay, morbidities, and mortalities were recorded. Results: There was a total of 167 patients with penetrating cardiac injuries identified. There were 151 (90.4%) males, with an overall median age of 29 years (IQR 24–34). Stab wounds accounted for 77.8% of the injuries, while gunshot wounds (GSW) accounted for 22.2%. The median injury severity score (ISS) and revised trauma score (RTS) were 25 and 7.1, respectively. The right ventricle was the most injured chamber (34.7%), followed by the left ventricle (29.3%), right auricle (13.2%), right atrium (10.2%), and combined injuries accounted for 7% of injuries. A commonly used incision was a sternotomy (51.5%), left anterior-lateral thoracotomy (26.9%), emergency room thoracotomy (19.2%), and clamshell thoracotomy (2.4%). The overall mortality rate was 40.7%, with a 29.2% mortality in the stab wounds. Twenty-four (14.4%) patients died in the emergency department, sixteen (9.6%) patients died on the table in theatre, and the remaining twenty-eight (16.7%) died in the intensive care unit or wards. Gunshot wounds, other associated injuries, right ventricle injuries, a high ISS, low RTS, and low Glasgow coma scale were all significantly more likely to result in death (p < 0.001). Conclusions: Penetrating cardiac injuries are often fatal, but the mortality can be improved with appropriate resuscitation and a work-up. The injuries to the heart can be safely managed by trauma/general surgeons in our setting. The physiology in presentation and other associated injuries determines outcomes in patients with penetrating cardiac injury.
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Trukhan, A. P., D. V. Alkhovik, I. G. Kosinsky, V. A. Koryachkin, V. A. Porkhanov, and I. Yu Zherkal. "REPUBLICAN CENTER FOR TREATMENT OF GUNSHOT WOUNDS AND MINE-EXPLOSIVE INJURIES: 3 YEARS OF EXPERIENCE AND TRENDS OF DEVELOPMENT." Novosti Khirurgii 29, no. 2 (April 21, 2021): 207–12. http://dx.doi.org/10.18484/2305-0047.2021.2.207.
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Objective. To evaluate the results of organizational measures for improving the efficiency of the Republican Center for the treatment of gunshot wounds and mine-explosive injuries. Methods. The study is based on an analysis of the work of the Republican Center for the treatment of gunshot wounds and mine-explosive injuries and includes patients (n=54) who were treated from November 1, 2016 to October 31, 2019. Gunshot wounds were detected in 42 patients (77.8%). Explosive trauma was detected in 12 patients (22.2%). The most common causes of injuries were personal carelessness (20 cases (37.0%)), carelessness of others (16 cases (29.6%)), suicidal attempts (9 cases (16.6%)). In accordance with the purpose of the survey, three equal time intervals (three periods) each being equal to one year were studied. The following indicators were analyzed: the number of patients, the time from the moment of injuring to hospitalization, the type of patient’s transportation, the quality of surgical care at the hospitalization stages. Results. Implementation of the proposed organizational measures allowed increasing the number of patients hospitalized into the Republican Center for the treatment of gunshot wounds and mine-explosive injuries during the third year of work by 66.7% and 78.6%, respectively, compared with the previous time intervals. The frequency of hospitalization of patients within 24 hours after receiving an injury increased from 66.7% to 72.7%, and among patients who are not military personnel - from 45.5% to 69.2%. The proportion of errors in the treatment of patients with gunshot wounds and explosive injuries decreased by 34.0%. Conclusion. The proposed organizational measures allowed increasing the efficiency of the Republican Center for the treatment of gunshot wounds and mine-explosive injuries. In the future, it is advisable to continue close cooperation with healthcare organizations and to improve the regulatory framework for the treatment of gunshot wounds of various localization. What this paper adds The paper presents the results of the analysis of three-year work of the RepublicanCenter for the treatment of gunshot wounds and mine-explosive injuries.Realization of the proposed organizational measures allowed increasing the number of hospitalized patients, shortening the period from injury to hospitalization, and reducing the number of errors in patient care.
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Ramasamy, A., SE Harrisson, MPM Stewart, and M. Midwinter. "Penetrating Missile Injuries During the Iraqi Insurgency." Annals of The Royal College of Surgeons of England 91, no. 7 (October 2009): 551–58. http://dx.doi.org/10.1308/003588409x464720.
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INTRODUCTION Since the invasion of Iraq in 2003, the conflict has evolved from asymmetric warfare to a counter-insurgency operation. This study investigates the pattern of wounding and types of injuries seen in casualties of hostile action presenting to a British military field hospital during the present conflict. PATIENTS AND METHODS Data were prospectively collected on 100 consecutive patients either injured or killed from hostile action from January 2006 who presented to the sole coalition field hospital in southern Iraq. RESULTS Eighty-two casualties presented with penetrating missile injuries from hostile action. Three subsequently died of wounds (3.7%). Forty-six (56.1%) casualties had their initial surgery performed by British military surgeons. Twenty casualties (24.4%) sustained gunshot wounds, 62 (75.6%) suffered injuries from fragmentation weapons. These 82 casualties were injured in 55 incidents (mean, 1.49 casualties; range 1–6 casualties) and sustained a total 236 wounds (mean, 2.88 wounds) affecting a mean 2.4 body regions per patient. Improvised explosive devices were responsible for a mean 2.31 casualties (range, 1–4 casualties) per incident. CONCLUSIONS The current insurgency in Iraq illustrates the likely evolution of modern, low-intensity, urban conflict. Improvised explosive devices employed against both military and civilian targets have become a major cause of injury. With the current global threat from terrorist bombings, both military and civilian surgeons should be aware of the spectrum and emergent management of the injuries caused by these weapons.
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Stekolnikov, A. A., and M. A. Ladanova. "TECHNOLOGICAL INJURIES IN INDUSTRIAL PIG FARMING." International bulletin of Veterinary Medicine 1 (2020): 135–39. http://dx.doi.org/10.17238/issn2072-2419.2020.1.135.
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Industrial injuries in pig farms of closed type are a very common pathology. Howev-er, nowadays, injury prevention and treat-ment of sick animals in the conditions of industrial pig breeding complex do not bring good results and require improvements. Ac-cording to the literature, there is no infor-mation about the results of the use of oint-ments and immuno- stimulators in the treat-ment of pigs with bitten wounds of the ears, tails and other parts of the body. In this re-gard, we have set a goal to develop therapeu-tic measures for injuries of piglets in a pig breeding complex of a closed type. We ana-lyzed the prevalence of industrial injuries in pigs. During the clinical examination, we studied the specific structures of injuries. The main cause of pigs injuries in industrial farming is cannibalism. In 28 days, 60% of pigs in the second experimental group, showed complete cicatrization of the wound, and 40% of animals showed this process regenerated on 85-95%, meanwhile 2 days they also had complete scarring of the wound. In 28 days, 50% of pigs of the third experimental group had a complete cicatriza-tion of the wound, and for 50% were ob-served scarring of the wound by 75-85%, and only after 4 days they demonstrated the complete scaring of the defect. For the treatment of bitten wounds as a result of developing cannibalism, it is recommended, to use local treatment of wounds with chlor-hexidine solution and argosulfan ointment daily 2 times a day and also to use the im-munostimulator “Ferrovir” in a dose of 1.0 ml/m2 per week. Such scheme of treatment of bitten wounds gives the best therapeutic effect.
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Grossman, Michael D., Patrick Reilly, Damian Mcmahan, Donald Kauder, and C. W. Schwab. "Gunshot Wounds below the Popliteal Fossa: A Contemporary Review." American Surgeon 65, no. 4 (April 1999): 360–65. http://dx.doi.org/10.1177/000313489906500416.
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The management of extremity injuries above the knee has been well described, but the evaluation and treatment guidelines for penetrating injuries below the popliteal crease has received less attention. A 6-year retrospective review of 100 patients who sustained isolated below-knee gunshot wounds. Patients with proximal extremity, torso, or head wounds were excluded from review so that we could focus on principles of managing below-knee wounds. All patients were evaluated with complete physical examination, ankle-brachial index, and plain X-rays. One patient presented with hemodynamic instability. Twenty-four patients underwent arteriography based on physical examination, an ankle-brachial index less than 0.9, or both. Twenty-two vascular injuries were identified in 19 patients, and an additional injury was found in a patient who went directly to surgery for pulsatile bleeding. Six of these 22 vascular injuries required treatment for bleeding or arteriovenous fistula. Treatment was by embolization in 5 and surgical ligation in 1. Thirteen patients had compartment syndromes. Thirty-five patients had fractures, and ten (29%) of these had an associated vascular injury. Four patients had peroneal nerve injuries, and three of these had long term disability. No limb loss or death occurred. We conclude that patients with low-velocity below-knee gunshot wounds sustain fractures, vascular injuries, compartment syndromes, and nerve injuries, in decreasing order of frequency. Arteriography and embolization may be useful to control bleeding; vascular reconstruction was unnecessary in our experience, and limb loss did not occur.
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Sizyi, M. Yu. "Septic complications in patients with neck wounds." Експериментальна і клінічна медицина 84, no. 3 (August 21, 2020): 64–66. http://dx.doi.org/10.35339/ekm.2019.84.03.10.
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Nowadays, we have been a steady increase in injuries as the social conditions of life and have changed. Statistically found that 54.0 % of people of car accidents have injuries to the head and neck. According to the literature, mortality in patients with neck injury which is complicating by pyoinflammatory persists up to 30.0-76.0 %. The management of neck trauma can be challenging and sometimes overwhelming, as this anatomical region contains many vital structures. These structures may pose a diagnostic and therapeutic dilemma. Our research based on the results of diagnosis and treatment of 124 patients with a purulent mediastinitis, complicating traumatic injuries of the neck organs. Among these men – 92 (74.2 %), women – 32 (25.8 %). The results of treatment depend on timely diagnosis, hospitalization in a specialized compartment and conducting active surgical tactics
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Kaufman, Howard H. "Treatment of head injuries in the American Civil War." Journal of Neurosurgery 78, no. 5 (May 1993): 838–45. http://dx.doi.org/10.3171/jns.1993.78.5.0838.
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✓ At the time of the American Civil War (1861–1865), a great deal was known about closed head injury and gunshot wounds to the head. Compression was differentiated from concussion, but localization of lesions was not precise. Ether and especially chloroform were used to provide anesthesia. Failure to understand how to prevent infection discouraged physicians from aggressive surgery. Manuals written to educate inexperienced doctors at the onset of the war provide an overview of the advice given by senior surgeons. The Union experiences in the treatment of head injury in the Civil War were discussed in the three surgical volumes of The Medical and Surgical History of the War of the Rebellion. Wounds were divided into incised and puncture wounds, blunt injuries, and gunshot wounds, which were analyzed separately. Because the patients were not stratified by severity of injury and because there was no neuroimaging, it is difficult to understand the clinical problems and the effectiveness of surgery. Almost immediately after the war, increased knowledge about cerebral localization and the development of antisepsis (and then asepsis) permitted the development of modern neurosurgery.
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Siracuse, Jeffrey, Alik Farber, Thomas W. Cheng, Yi Zuo, Douglas W. Jones, Jeffrey Kalish, and Bindu Kalesan. "IP259. Analysis of Vascular Injuries After Gunshot Wounds." Journal of Vascular Surgery 67, no. 6 (June 2018): e155. http://dx.doi.org/10.1016/j.jvs.2018.03.214.
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Campion, T., and S. Cross. "The spectrum of injuries in buttock stab wounds." Clinical Radiology 72, no. 7 (July 2017): 543–51. http://dx.doi.org/10.1016/j.crad.2017.02.009.
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Lee, Dennis, Michael Nash, Jon Turk, and Gady Har-El. "Low-Velocity Gunshot Wounds to the Paranasal Sinuses." Otolaryngology–Head and Neck Surgery 116, no. 3 (March 1997): 372–78. http://dx.doi.org/10.1016/s0194-59989770276-6.
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There are more than 200 million private firearms in the United States today. Firearm-associated deaths are the second leading cause of mortality for men 1 to 38 years of age. There are many studies in the literature concerning the management of high-velocity gunshot injuries to the head and neck. However, there are no studies in the English language literature concerning the management of isolated low-velocity gunshot wounds to the paranasal sinuses. We retrospectively reviewed 35 patients treated for low-velocity gunshot wounds of the paranasal sinuses between 1985 and 1994 at Kings County Hospital Center. The injuries sustained by these patients were less severe than previously reported for high-velocity missile or shotgun injuries. The management of these injuries is outlined with emphasis on (1) indications for angiographic studies, (2) airway management, and (3) indications for operative removal of bullet fragments.
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Rouse, D. A. "Patterns of Stab Wounds: A Six Year Study." Medicine, Science and the Law 34, no. 1 (January 1994): 67–71. http://dx.doi.org/10.1177/002580249403400110.
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A series of 156 consecutive deaths from stabbing were analysed for age and sex of victim, number and size of wounds, the incidence and pattern of defence wounds, the association with other injuries and the pattern of self-inflicted wounds.
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Cicák, A., and I. Mihál. "Can artificial wounding of beech stems induce necroses?" Journal of Forest Science 51, No. 12 (January 10, 2012): 559–63. http://dx.doi.org/10.17221/4588-jfs.
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The paper presents data on the induction of necroses after small injuries to beech stems caused by electrodes during measuring cambium electric resistance. Altogether 121 beech stems of tree class 1–3 (according to Kraft) were evaluated. Among 2,904 mechanical injuries in 121 stems evaluated (24 per stem), 155 injuries induced necroses, hence each 19<sup>th</sup> injury induced necrosis. Most stems (33.06%) showed one necrosis, few stems (4.96%) showed even four necroses. 28.93% of stems did not show any necrosis. In order to prevent the infection of wounds and subsequent induction of necroses the authors recommend to treat any wounds with a suitable fungicide after using an equipment causing even negligible wounds of stems.
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Kozachenko, Ihor. "Nonfatal air gun shot trauma: structural analysis and morphological features injuries." Forensic-medical examination, no. 2 (December 30, 2016): 47–51. http://dx.doi.org/10.24061/2707-8728.2.2016.10.
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In practical activities of the Ukrainian bureau of forensic we increasingly come across cases of nonfatal air gun injuries. However, experts lack a common methodological approaches for forensic evaluation of injuries, particularly during the examination of living people. An earlier analysis of nonfatal air gun injuries made on materials of only two regional bureau of forensic medical examination, a purely local nature used on a small number of cases using some general parameters can provide processing methodology study of air gun injuries and practical recommendations for the implementation of forensic medical examinations. 127 cases of «Expert’s conclusions» and «Acts of the forensic examination» were investigated, taken from 21 bureaus all regions of Ukraine during the period of 2006-2015, in which was performed forensic medical examinations in cases nonfatal air guns injuries.Discussion. The main causes of nonfatal air gun injuries are named as hooliganism, domestic conflicts, careless handling of weapons and robbery. Among the injured men is 86 %, women – 14 %. Injuries made mostly of air pistols and rifles, caliber 4.5mm. Among the weapons 8 models applied rifles large and extra large capacity. Most commonlywounded parts were head (38 %), chest (17,3 %) and lower limbs (16 %), less common – upper limbs (10,2 %) and neck (3,9 %). Input air gun injuries are mainly wounds (74 %), sometimes abrasions (23 %) and bruising (3 %). The nature and volume air gun injuries primarily dependent on the power of the applied weapon and the affected areas of the body, penetrating wounds from shots of powerful guns are accompanied by injuries of the brain and spinal cord, internal organsof the chest and abdomen bleedings, fractures of the skull, vertebrae, ribs and scapula; of shots from pistols and rifles low penetrating injuries were observed only in the cranial cavity, mostly after bullet passing an eyeball.Conclusions:1. The main causes of nonfatal air gun shot trauma were hooliganism, domestic violence, accidents and robberies. Among the casualties men is 86 %, women – 14 %.2. Injuries made mostly of air pistols and rifles, caliber 4.5mm including extra large power rifles.3. Most cases provided head, chest and lower limbs wounds, fewer cases of upper limbs and neck injuries were observed.4. High and extra large power rifles more caused penetrating air gunshot wounds of major body cavities with injury to the brain and spinal cord, internal organs with hemorrhages and bone fractures. Pistols and low power rifles caused penetrating injuries only in the cranial cavity, commonly after passing projectile eyeball.5. The majority of wounds are defined as minor injuries. Injuries of moderate severity made up only 2%. Serious injuries attributed to 13% according hazard to life and complete loss of sight.
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Bhandari, Prem Singh, Mrinal Kanti Mukherjee, and Sanjay Maurya. "Reconstructive challenges in war wounds." Indian Journal of Plastic Surgery 45, no. 02 (May 2012): 332–39. http://dx.doi.org/10.4103/0970-0358.101316.
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ABSTRACTWar wounds are devastating with extensive soft tissue and osseous destruction and heavy contamination. War casualties generally reach the reconstructive surgery centre after a delayed period due to additional injuries to the vital organs. This delay in their transfer to a tertiary care centre is responsible for progressive deterioration in wound conditions. In the prevailing circumstances, a majority of war wounds undergo delayed reconstruction, after a series of debridements. In the recent military conflicts, hydrosurgery jet debridement and negative pressure wound therapy have been successfully used in the preparation of war wounds. In war injuries, due to a heavy casualty load, a faster and reliable method of reconstruction is aimed at. Pedicle flaps in extremities provide rapid and reliable cover in extremity wounds. Large complex defects can be reconstructed using microvascular free flaps in a single stage. This article highlights the peculiarities and the challenges encountered in the reconstruction of these ghastly wounds.
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O’Connor, Siobhán, Peta L. Hitchens, and Lauren V. Fortington. "Hospital-treated injuries from horse riding in Victoria, Australia: time to refocus on injury prevention?" BMJ Open Sport & Exercise Medicine 4, no. 1 (February 2018): e000321. http://dx.doi.org/10.1136/bmjsem-2017-000321.
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BackgroundThe most recent report on hospital-treated horse-riding injuries in Victoria was published 20 years ago. Since then, injury countermeasures and new technology have aimed to make horse riding safer for participants. This study provides an update of horse-riding injuries that required hospital treatment in Victoria and examines changes in injury patterns compared with the earlier study.MethodsHorse-riding injuries that required hospital treatment (hospital admission (HA) or emergency department (ED) presentations) were extracted from routinely collected data from public and private hospitals in Victoria from 2002–2003 to 2015–2016. Injury incidence rates per 100 000 Victorian population per financial year and age-stratified and sex-stratified injury incidence rates are presented. Poisson regression was used to examine trends in injury rates over the study period.ResultsED presentation and HA rates were 31.1 and 6.6 per 100 000 person-years, increasing by 28.8% and 47.6% from 2002 to 2016, respectively. Female riders (47.3 ED and 10.1 HA per 100 000 person-years) and those aged between 10 and 14 years (87.8 ED and 15.7 HA per 100 000 person-years) had the highest incidence rates. Fractures (ED 29.4%; HA 56.5%) and head injuries (ED 15.4%; HA 18.9%) were the most common injuries. HA had a mean stay of 2.6±4.1 days, and the mean cost per HA was $A5096±8345.ConclusionHorse-riding injuries have remained similar in their pattern (eg, types of injuries) since last reported in Victoria. HA and ED incidence rates have increased over the last 14 years. Refocusing on injury prevention countermeasures is recommended along with a clear plan for implementation and evaluation of their effectiveness in reducing injury.
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G'sell, David, Jeffrey E. Carter, Nicole M. Kopari, and William L. Hickerson. "725 Case Series: New Porcine Placental ECM for Burn Injuries." Journal of Burn Care & Research 43, Supplement_1 (March 23, 2022): S168—S169. http://dx.doi.org/10.1093/jbcr/irac012.279.
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Abstract Introduction Human amniotic membrane (HAM) has been used as a biologic dressing for burn wounds since 1955 but limited due to availability, size, and processing costs. In 2021 a new porcine placental product was FDA-approved overcoming challenges with human-sourced products. Our study is the first case series to report outcomes using porcine placental extracellular matrix (PPECM) in the use of adult burn patients. Methods Adults with thermal burns resulting in partial-thickness burn wounds (PTBW) were consented and included in the study from 03/2021 to 09/2021. Patients with full-thickness injures, concomitant trauma, or adverse beliefs to porcine products were not included in the study. Serial still images and initial wound measurements were obtained intraoperatively and post-operatively. PPECM trial product processed with a proprietary decellularization method to produce single sheets up to 15x20cm was approved by the facility value assessment committee. Adverse events were defined a priori as infection, increased pain or itching relative to adjacent autografts, or failure to heal. Infection was defined as a PPECM treatment site requiring any change from standard of care or initiation of local or systemic antibiotics. Pain was assessed using a visual analogue scale. Itching was assessed at discharge and follow-up. Healing was assessed using the FDA guidance for wound closure with 2 consecutive visits 2 weeks apart demonstrating 100% epithelialization without drainage or dressing requirements. Results Four patients were treated during the study period with wounds involving the torso and major joints such as the hands/wrists and knees. None of the PPECM wounds demonstrated failure to heal or required revision excision, or autograft. None of the PPECM wounds had evidence of infection. PPECM wounds had decreased pain/itching relative to adjacent burn wounds which were treated with split-thickness autograft, autologous skin cell suspension, or allogeneic cultured skin substitute (VAS mean 1 vs 3.1). Healing was noted in all wounds at 1-week primary dressing removal with confirmation at 2-week interval follow-up. Conclusions PPECM treatment of PTBW was not associated with adverse events and resulted in favorable outcomes clinically. The large size, ease of use, and lower costs relative to HAM is an intriguing alternative for PTBW. Comparative studies are needed in the field to determine best practices and overall value.
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Dore, J. "The cost of severe spinal cord injuries and traumatic brain injuries in Victoria." Injury 40 (February 2009): S1—S2. http://dx.doi.org/10.1016/j.injury.2009.01.022.
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