Статті в журналах з теми "Wounds and injuries"
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1
Vasil’ev, A. Yu, and I. S. Obelchak. "Multidetector computed tomography in the diagnosis of lesions of the main vessels for gunshot injury of the chest." Regional blood circulation and microcirculation 18, no. 1 (May 3, 2019): 31–38. http://dx.doi.org/10.24884/1682-6655-2019-18-1-31-38.
Анотація:
Purpose – examine the possibilities of multislice computed tomangiography (MSCTA) in case of suspected damage to the great vessels in a chest gunshot fghting injury.Material and methods. A radiation survey of 130 wounded with gunshot injuries of the chest to assess the nature, diagnosis of gunshot injuries of the vascular bed.Results. Of the 130 wounded with gunshot wounds to the chest, 41 (31.5 %) of the injured had gunshot wounds to the chest were nonpenetrating, and 89 (68.5 %) had penetrating injuries. In 76 (58.4 %) patients with gunshot chest injuries, the nature of the wound was fragmentation, in 54 (41.6 %), wounds were bullet wounds. In the algorithm of radiation examination of patients with gunshot wounds of the chest to identify the nature of damage to the organs of the mediastinum and vascular structures, the main method of visualization was MSCT with contrast enhancement. Damage to the bone skeleton of the chest (ribs, collarbone, sternum, scapula) by MSCT was observed in 23 (17.6 %) patients. Almost half – 66 (50.1 %) of the wounded with gunshot injuries during MSCT examination, traumatic injury (pulmonitis) of the lung was observed. In 2 (1.5 %) cases, damage to the heart was detected that was not recognized at the stage of skilled surgical care. False posttraumatic aneurysm of the thoracic aorta was diagnosed in two wounded. Accuracy, sensitivity, specifcity of MSCT angiography in imaging of the vascular bed and diagnosis of damage to the great vessels of the chest cavity was 98, 97 and 97 %, respectively.Conclusions. MSCT made it possible to reliably assess the nature of the gunshot injuries of the chest, identify timely damage to the great vessels of the mediastinum, determine the localization of the foreign injuring bodies near the vascular structures, and determine the surgical tactics.
2
Singh, Niten, Eric Bluman, Benjamin Starnes, and Charles Andersen. "Dynamic Wound Closure for Decompressive Leg Fasciotomy Wounds." American Surgeon 74, no. 3 (March 2008): 217–20. http://dx.doi.org/10.1177/000313480807400307.
Анотація:
Decompressive fasciotomy for preservation of lower extremity function and salvage is an essential technique in trauma. The wounds that result from the standard two incision four-compartment leg fasciotomy are often accompanied by a wide soft tissue opening that in the face of true compartment syndrome are often impossible to close in a delayed primary fashion. We describe a technique using a device that allows for dissipation of the workload across the wound margin allowing for successful delayed primary closure. Consecutive patients who presented to the 28th Combat Support Hospital in Baghdad, Iraq with a diagnosis of compartment syndrome of the leg, impending compartment syndrome of the leg, or compartment syndrome of the leg recently treated with fasciotomies were followed. All patients underwent placement of the Canica dynamic wound closure device (Canica, Almonte, ON, Canada). Eleven consecutive patients treated at a combat support hospital in support of Operation Iraqi Freedom underwent four-compartment fasciotomies for penetrating injuries. There were five patients that underwent a vascular repair [three superficial femoral artery (SFA) injuries and two below knee popliteal artery injuries] and six patients that had orthopedic injuries (three comminuted tibial fractures, two fibula fractures, and one closed pilon fracture). Patients returned to the operating room within 24 hours for washout and wound inspection. Mean initial wound size was 8.1 cm; mean postplacement size was 2.7 cm; average time to closure was 2.6 days. All patients were able to undergo primary wound closure of the medial incision and placement of the Canica device over the lateral incision. Ten of the 11 patients (91%) could be closed in delayed primary fashion after application of the device. In our series of patients with penetrating wartime injuries and compartment syndrome of the leg we have found the use of this dynamic wound closure device to be extremely successful and expedient.
3
Golovko, K. P., V. Yu Markevich, T. Yu Suprun, A. B. Vertiy, S. E. Komyagin, N. A. Zhirnova, and I. M. Samokhvalov. "Prospects for improving pre-hospital care for wounded with gunshot penetrating wounds to the chest." Bulletin of the Russian Military Medical Academy 22, no. 3 (December 15, 2020): 140–47. http://dx.doi.org/10.17816/brmma50550.
Анотація:
Abstract. The analysis of injuries, life-threatening consequences and outcomes of treatment of wounded with penetrating chest wounds and the results of approbation of a prototype (medical) disposable set UD-02v for the elimination of strained and open pneumothorax, hemothorax, pleural drainage and collection of spilled blood with the possibility of subsequent reinfusion at the pre-hospital stage is presented. The prototype of the UD-02v set was created as part of the implementation of the state defense order in 2018. Its creation is due to the fact that despite the improvement of medical care at the stages of medical evacuation and the widespread use of individual armor protection, chest injuries currently remain a frequent type of combat surgical injury, accounting for 6 to 12% of all injuries. The main cause of death of injured and injured with chest injuries remains blood loss caused by continuing intrapleural bleeding and concomitant damage to other anatomical areas. Stressful pneumothorax, together with intrapleural bleeding, account for 93% of preventable causes of fatal chest injuries at the pre-hospital stage. Untimely elimination of the consequences of severe breast injuries should be considered as a negative factor affecting the outcome of treatment, and significant improvement in treatment results should be expected only in the case of early elimination of the most severe consequences of breast injuries. The developed set of UD-02v exceeds foreign medical devices in its medical and technical characteristics, and is the most promising for acceptance for the supply of the Armed forces of the Russian Federation as part of the samples of complete and service equipment.
4
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.
Анотація:
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.
5
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.
Анотація:
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.
6
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.
Анотація:
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.
7
Khomenko, I. P., K. P. Gerzhyk, and B. M. Kucher. "The place and role of videothoracoscopic surgical interventions in war wounds and injuries of the chest organs." Reports of Vinnytsia National Medical University 22, no. 3 (September 28, 2018): 522–24. http://dx.doi.org/10.31393/reports-vnmedical-2018-22(3)-26.
Анотація:
Thoracic injuries are considered to be one of the most severe injuries of human systems and organs, which are characterized by a large number of complications and high mortality. According to the ATO data in eastern Ukraine, the frequency of chest injuries in the general structure of combat surgical injuries is 11.7%, the overwhelming majority of which were non-penetrating injuries (83.6%). The overall mortality rate for penetrating wounds of the breast is 5–10%. Surgical tactics for injuries and injuries of the chest is diverse and depends on the type of traumatic injury, the time of first medical and specialized care, the severity of the condition of the victims, the presence of complications, the technical capabilities of the hospital. Objective: optimization of surgical tactics for wounds and injuries of the chest through the use of video-assisted thoracoscopic techniques. A retrospective analysis of the surgical treatment of 103 thoracic wounded and injured, which were located in the Military Medical Clinical Center of the Southern Region in Odessa and the area of responsibility (level II–IV medical care) from June 2014 to July 2017, was carried out. At the stages of medical evacuation of all 103 thoracic wounded and injured in most cases (41 people (39.8%)), drainage of the pleural cavity was sufficient to eliminate hemo- and pneumothorax — 25 (24.3%) underwent various surgical interventions from thoracotomic approaches, 16 (15.5%) had various video-assisted thoracoscopic surgeries, 16 (15.5%) had only surgical treatments for gunshot wounds, and 5 (4.9%) wounded and injured had only conservative therapy. Conclusions: Promising, in our opinion, can be the widespread introduction of video-assisted thoracoscopic interventions into the practice of surgeons who are involved in the ATO, followed by a multicenter assessment of the results.
8
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.
Анотація:
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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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.
Анотація:
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.
10
Kotiv, B. N., I. M. Samokhvalov, V. Ju Markevich, I. I. Dzidzava, O. V. Barinov, V. V. Suvorov, A. V. Goncharov, and K. V. Petukhov. "Thoracoabdominal stab wounds: modern surgical tactics." Grekov's Bulletin of Surgery 178, no. 1 (March 28, 2019): 34–38. http://dx.doi.org/10.24884/0042-4625-2019-178-1-34-38.
Анотація:
Theobjectivewas to determine the optimal therapeutic and diagnostic algorithm for thoracoabdominal injury.Material and methods. The results of the examination and treatment of 389 injured patients with combined stab wounds of chest and abdomen were analyzed. The injuries were thoracoabdominal in 54 (13.9 %) cases.Results. We analyzed instrumental invasive and non-invasive diagnostic methods. The sequence of surgical interventions was determined.Conclusion. We revealed that the correct sequence and volume of surgical intervention ensured the success of treating the injured patients, while in cases of competing sources of bleeding, priority should be given in favor of performing thoracotomy.
11
Danchyn, A. O., O. M. Goncharuk, S. A. Usatov, M. S. Altabury, and G. O. Danchyn. "Biophysical mechanisms of the formation of wound channels in non-penetrating gunshot craniocerebral wounds." Ukrainian Interventional Neuroradiology and Surgery 35, no. 1 (June 30, 2021): 33–42. http://dx.doi.org/10.26683/2786-4855-2021-1(35)-33-42.
Анотація:
Objective ‒ to develop recommendations for optimization of primary surgical treatment of gunshot penetrating craniocerebral wounds on the basis of theoretical and applied study of one of the sections of wound ballistics ‒ biophysical mechanisms of wound canal formation, concomitant impenetrable wounds and intracranial injuries.Materials and methods. The medical histories of 155 wounded who received a non-pe-netrating craniocerebral injury during the hostilities in the East of Ukraine in 2014‒2020 were studied. All of the wounded were males between 18 and 60 years old (mean age ‒ 35.1 years). To study the biophysical features of the formation of different types of wound canals at a given non-lethal kinetic energy transferred to the head tissues, the type of the wounding projectile, the flight trajectory, the nature of gunshot injuries to the soft tissues of the cranial vault and skull fractures and intracranial injuries were determined according to the data of clinical stu-dies and computed tomography and compared with the results of theoretical studies using the laws of wound ballistics.Results. There were 11 (7.1 %) bullet (only tangential) wounds, and 144 (92.9 %) shrapnel. The formation of wound channels depends on the type of the wounding projectile and its kinetic energy. Non-penetrating firearms bullet and shrapnel tangential craniocerebral wounds are caused by the destructive effect of injuring shells on the tissues, which at the moment of collision with the head have both destructive kinetic energy (>80 J) and less than destructive kinetic energy. Blind craniocerebral injuries are caused only by the traumatic effects of fragments with a small (<80 J) kinetic energy.Conclusions. With gunshot non-penetrating single shrapnel blind wounds, the wounds do not have a zone of secondary necrosis, and the zone of primary necrosis is small or insignificant, which makes it possible not to carve soft tissues around the wound during primary surgical treatment, but only to remove necrotic tissues. With gunshot non-penetrating shrapnel tangential and blind craniocerebral wounds, when the soft tissue wounds of the cranial vault do not gap, small size (damage to the skin, subcutaneous tissue to aponeurosis), primary surgical treatment is not performed. Such wounds are treated with a toilet and aseptic dressings. Wound canals ending in gunshot fractures are subject to primary surgical treatment in the same way as gunshot fractures.
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Yetiser, Sertac, and Mustafa Kahramanyol. "High-Velocity Gunshot Wounds to the Head and Neck: A Review of Wound Ballistics." Military Medicine 163, no. 5 (May 1, 1998): 346–51. http://dx.doi.org/10.1093/milmed/163.5.346.
Анотація:
Abstract Patients who sustain gunshot injuries to the head and neck face heavy tissue damage and eventually life-threatening conditions. A very significant factor that determines the degree of injury is the course and extent of the missile track. The missile track is well correlated with bullet structure, size, and velocity, which have distinct features in civilian and military firearm injuries. The missile entrance or exit wound may be out of sight in some injuries, and often it is difficult to predict the severity of the injury in the chaotic circumstances of the battlefield. We studied the wound ballistics in five soldiers who suffered penetrating cranial and cervical firearm injuries.
13
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.
Анотація:
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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Golubovic, Zoran, Vojkan Stanic, Srbobran Trenkic, Predrag Stojiljkovic, Goran Stevanovic, Aleksandar Lesic, Ivan Golubovic, Dragan Milic, Aleksandar Visnjic, and Stevo Najman. "Penetrating injury of the lungs and multiple injuries of lower extremities caused by aircraft bombs splinters." Vojnosanitetski pregled 67, no. 8 (2010): 688–93. http://dx.doi.org/10.2298/vsp1008688g.
Анотація:
Introduction. Injuries caused by aircraft bombs cause severe damages to the human body. They are characterized by massive destruction of injured tissues and organs, primary contamination by polymorph bacterial flora and modified reactivity of the body. Upon being wounded by aircraft bombs projectiles a victim simultaneously sustains severe damages of many organs and organ systems due to the fact that a large number of projectiles at the same time injure the chest, stomach, head and extremities. Case report. We presented a patient, 41 years of age, injured by aircraft bomb with hemo-pneumothorax and destruction of the bone and soft tissue structures of the foot, as well as the treatment result of such heavy injuries. After receiving thoracocentesis and short reanimation, the patient underwent surgical procedure. The team performed thoracotomy, primary treatment of the wound and atypical resection of the left lung. Thoracic drains were placed. The wounds on the lower leg and feet were treated primarily. Due to massive destruction of bone tissue of the right foot by cluster bomb splinters, and impossibility of reconstruction of the foot, guillotine amputation of the right lower leg was performed. Twelve days after the wounding caused by cluster bomb splinters, soft tissue of the left lower leg was covered by Tirsch free transplantant and the defect in the area of the left foot was covered by dorsalis pedis flap. The transplant and flap were accepted and the donor sites were epithelized. Twenty-six days following the wounding reamputation was performed and amputation stump of the right lower leg was closed. The patient was given a lower leg prosthesis with which he could move. Conclusion. Upon being wounded by aircraft bomb splinters, the injured person sustains severe wounds of multiple organs and organ systems due to simultaneous injuries caused by a large number of projectiles. It is necessary to take care of the vital organs first because they directly threaten the life of the wounded patient. Despite adequate surgical treatment of war wounds of the feet, because of massive defect of bone and soft tissue, amputation may be the only rational solution of the treatment. The resection of the lung may be successful method for the severe destruction of the lung.
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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.
Анотація:
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.
16
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.
Анотація:
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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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.
Анотація:
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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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.
Анотація:
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.
Анотація:
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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Jalili, Reza, Myriam Maude Verly, Breshell Russ, Ruhangiz T. Kilani, and Aziz Ghahary. "645 Topical Application of a Novel Powdered Scaffold for Rapid Treatment of Skin Injuries." Journal of Burn Care & Research 41, Supplement_1 (March 2020): S168—S169. http://dx.doi.org/10.1093/jbcr/iraa024.265.
Анотація:
Abstract Introduction In large skin injuries, lack of matrix deposition impedes timely healing process. The longer a wound remains open, the greater is the risk of infection, non-healing, and other complications. It is therefore crucial to find effective means to promote rapid closure of skin defects. Our group has previously developed a liquid in situ-forming nutritional scaffold, known as MeshFill (MF). MF has been previously proven to be very effective in accelerating the wound repair process, notably that of complex wounds. However, MF is limited in its application to deep and tunnelling wounds, and requires reconstitution with a solvent as well as maintenance at cold temperature until application. To address these limitations, our group has developed a powdered form of MF for rapid topical application on superficial skin injuries such as dehisced surgical wounds and burn injuries. Methods Our goal was to investigate whether a powdered form of MF could be directly applied onto the wounds to accelerate healing. Ideally, powdered MF would absorb the moisture within the wound environment and reconstitute into the gel form in situ. We examined the efficacy of powder MF (PMF) compared to reconstituted gel MF (GMF) and to a standard dressing protocol. To do so, splinted full thickness wounds were generated on the back of mice and treated with either PMF or GMF or were bandaged with no treatment (NT). The healing process was monitored until wounds were fully closed. Clinical wound measurements and histological assessments were performed to compare different treatment regimens. Results Application of both PMF and GMF accelerated wound epithelialization at days 7 and 14, compared to NT, and had faster wound closure times. On average, the PMF treatments healed 17% faster than the NT control, and the GMF treatments healed 21% faster than the NT control. No significant difference between PMF and GMF was found for any outcomes. Additionally, our results suggest that epidermis formation was more effective in P and MF conditions compared to NT. Conclusions These findings suggest that topical application of a powdered form of MeshFill is as effective as standard reconstituted MeshFill gel in accelerating the healing process of skin injuries. Applicability of Research to Practice Topical application of a powdered scaffold may be a very convenient and practical method for rapid treatment of large superficial wounds such as dehisced surgical wounds, burn injuries, and filling gaps in meshed skin grafts.
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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.
23
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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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.
Анотація:
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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Adaiyi, Obene Tonye, Abhulimen Victor , and Echem Richard . "Evaluation of Gunshot Wounds to the Extremities: Correlation of Red Cross Wound Score and Initial Response to Management." American Journal of Health, Medicine and Nursing Practice 7, no. 11 (September 14, 2022): 9–21. http://dx.doi.org/10.47672/ajhmn.1191.
Анотація:
Purpose: Gunshot wounds to the extremities are a major cause of death and disability. The Red Cross Wound Score (RCWS) is a simple classification system that is thought to fairly assess severity of injury, influence surgical management and a good predictor of outcome in gunshot wounds. This study aims to evaluate the correlation between the Red Cross Wound Score RCWS and initial response to management.
Methodology: This was a prospective study recruiting all consenting patients who suffered gunshot wounds to any extremity and presented at the University of Port Harcourt Teaching Hospital (UPTH). The study was conducted over a 12-month period between October 2018 and September 2019. Data on demographics, anatomical region of the body involved, type of gun time between injury and hospital presentation were obtained using a proforma. Analysis of extracted data was done by the aid of SPSS for Windows version 20.
Findings: A total of 106 wounds from 82 patients were analyzed; seventy males (85.4%) and 12 females. AK 47 rifles and locally fabricated pistols were the wounding weapons in 32.9% and the left leg (28.3%) was the most injured extremity. Fifty-two wounds (49%) were grade 3, 44 (41.5%) wounds grade 2 and 10 wounds (9.4%) grade 1. There was a positive association between RCWS grade 3 wounds and limb length discrepancy and joint stiffness. Vascular injuries were seen in 6 patients (0.07%). Wound infection (46.2%), joint stiffness (41.5%) and shortening (34%) were the common complications in the study. The study showed that young adult males suffered more gunshot wounds than females. Most of the wounds were RCWS grade 3 and there was a positive association between RCWS grade 3 wounds and limb length discrepancy and joint stiffness. Patients with longer mean presentation time had a higher infection rate.
Recommendations: The Red Cross wound classification should be adopted as a useful scoring system. Also, patients with gunshot injuries should present earlier to the hospital to reduce complications.
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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.
Анотація:
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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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.
Анотація:
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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Kim, Daniel H., Judith A. Murovic, Robert L. Tiel, and David G. Kline. "Penetrating injuries due to gunshot wounds involving the brachial plexus." Neurosurgical Focus 16, no. 5 (May 2004): 1–6. http://dx.doi.org/10.3171/foc.2004.16.5.4.
Анотація:
The authors review 118 operative brachial plexus gunshot wounds (GSWs), causing 293 element injuries that were managed over a 30-year period at Louisiana State University Health Sciences Center (LSUHSC). Retrospective chart reviews were performed. Using the LSUHSC grading system for motor sensory function, each element's grades were combined and averaged. Most of the 293 injured elements were found to have gross continuity at operation and of 202 elements with complete neurological loss, only 16 (8%) exhibited total disruption. Of 293 injuries, 128 elements with complete or incomplete loss were not only in continuity when explored but also had positive intraoperative nerve action potentials (NAPs). After neurolysis, 120 of 128 elements in continuity (94%) improved to greater than or equal to Grade 3 function. Elements not regenerating early usually required repair. One hundred fifty-six of 202 completely or incompletely injured elements (77%) required resection and suture or graft repair based on intraoperative NAPs. Neurolysis achieved greater than or equal to Grade 3 results in 42 (91%) of 46 elements with complete loss. Suture repair resulted in good outcomes in 14 (67%) of 21 and in 73 (54%) of 135 undergoing graft repairs (1 to 3.5 cm length) and presenting with complete loss. Of 91 incomplete elements, intraoperative NAPs were positive in 82 (90%) and 78 of 82 had good results. Nine had negative NAPs and six elements required suture repair. Three required grafts with results of greater than or equal to Grade 3 in five (83%) of six and two (67%) of three, respectively. Based on 118 patient results with 293 injured elements, guidelines for the management of GSWs were established as described in this paper.
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Tkachenko, Pavlo I., Serhii O. Bilokon, Olha B. Dolenko, Nataliia M. Korotych, Yuliia V. Popelo, and Nataliia P. Bilokon. "BITTEN WOUNDS OF THE MAXILLOFACIAL AREA IN CHILDREN." Wiadomości Lekarskie 73, no. 6 (2020): 1108–13. http://dx.doi.org/10.36740/wlek202006105.
Анотація:
The aim of the work is to determine the frequency, structure, features of clinical manifestations and treatment of bitten wounds of the face and neck in children of Poltava region. Materials and methods: It has been analyzed 91 histories of disease of thematic patients undergone treatment at the Surgical Department of Pediatric town clinical hospital of Poltava. Results: In the structure of traumatic injuries of maxillofacial area in children 5.3% were patients with bitten wounds of the face and neck. Among the injured were children of the age 7-12 years old (30.2%). In 74.7% of cases, the bites were complicated by acute inflammatory processes. Urban residents accounted for 71.8% of the total number of cases, while rural residents accounted for 28.2%. Boys were injured by 53.6% and girls by 46.4%. Sharps (74.5%), punctures (19.3%) and lacerations (6.2%) differed in form. The comprehensive treatment of patients with bitten maxillofacial area wounds was carried out according to the protocol of care. Conclusions: The clinical picture and severity of bitten wounds of maxillofacial area in children have individual features, which are largely due to topographic and anatomical localization of injuries. The choice of the optimal variant of primary surgical treatment of wounds and the amount of surgery should be determined individually depending on the severity of the injury, the time of injury. Special attention should be paid to normalization of psycho-emotional state of patients and prevention of scar formation.
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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.
Анотація:
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.
31
Zaporozhan, S. Y., D. B. Fira, and O. V. Pokryshko. "ANTIBACTERIAL THERAPY FOR PATIENTS WITH BURN INJURIES." International Journal of Medicine and Medical Research 8, no. 1 (September 5, 2022): 18–24. http://dx.doi.org/10.11603/ijmmr.2413-6077.2022.1.13098.
Анотація:
Background. Treatment of burn wound infection is an urgent issue of contemporary medicine, including surgery, combustiology and microbiology. It is established that infectious complications are a challenge for burn patients. In the course of wound reparation, infectious complications may worsen. Along with surgical treatment, mechanical removal of pathogens from burn wounds is also important as well as antimicrobials for patients with severe burns. Objective. The aim of the study was to define the most common pathogens of purulent-inflammatory complications of burn wounds and their susceptibility to antibiotics. Methods. The study involved patients treated at the Center of Thermal Trauma and Plastic Surgery of Lviv I-Territorial Medical Association, the unit of St. Luke Hospital of Lviv. Collection of material from wound secretions of burn wounds was performed with sterile swab. The study was performed before prescription of antibiotics, at the end of the first and second weeks of the disease. The pathogens were isolated and identified. Antibiotic susceptibility was studied using standard research methods. The obtained results were analyzed by means of the software package of the microbiological monitoring system WHONET 5.2 (WHO Collaborating Centre for Surveillance of Antimicrobial Resistance) and the program Microsoft Office Excel 2007. Results. The study of smears from burn wounds proved that 240 strains of gram-positive and gram-negative microorganisms that caused purulent-inflammatory processes were isolated. Among the selected causative agents of a burn wound complicated by a purulent-inflammatory process, gram-negative bacteria predominated (60.8% of all detected microorganisms). Gram-positive flora of S. epidermidis and S. aureus were more common in the wound surface during the first week of the disease. In most patients with severe burns, bacterial associations were isolated from the wound surface (66.3%) in two and three weeks, and in three weeks Candida spp. were isolated. Non-fermenting rods A. baumannii and P. aeruginosa dominated among the gram-negative flora isolated from the wound surface of burns. The analysis of susceptibility of microorganisms isolated from patients with burns to antibiotics showed that almost all of the cultures were polyresistant. Conclusions. Gram-negative microorganisms, strains of non-fermenting bacteria predominated among the pathogens isolated from burn wounds complicated by purulent inflammation; Staphylococcus aureus prevailed among the gram-positive ones. The most significant clinical strains were highly polyresistant to antibiotics.
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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.
Анотація:
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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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.
Анотація:
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
34
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.
Анотація:
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.
35
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.
Анотація:
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.
36
Mitchell, Suzanne, Dhaval Bhavsar, Jessica Reynolds, Jessica Jones, and Julia M. Pena. "734 A Comparison of Burn Depth Assessment Between Clinical Diagnosis and Laser Doppler Imaging." Journal of Burn Care & Research 41, Supplement_1 (March 2020): S199. http://dx.doi.org/10.1093/jbcr/iraa024.317.
Анотація:
Abstract Introduction Accurate burn assessment is crucial to prescribing appropriate treatment and is dependent upon the experience of the provider and the timing of diagnosis relative to the burn injury evaluation. Differentiating between a deep partial thickness and full thickness burn may not be easily discernible. To augment the clinical diagnosis of burn depth, a laser doppler image measures the microvascular blood flow of injured tissue to predict burn wound healing. The aim of this study is to evaluate the clinical assessment of burn wounds by experienced burn providers compared to the laser doppler image assessment in predicting which burn wounds should heal spontaneously in 3 weeks. Methods A retrospective chart review from 2012–2016, included 54 subjects. The clinical assessment included a description of burn variables relevant to the determination of spontaneous burn wound healing (burn depth, total body surface area, mechanism of injury, anatomical location, clinical burn depth diagnosis, and laser doppler image). A chi-square analysis compared the clinical diagnosis and the laser doppler assessment of burn wound depth, as well as the correlation between clinical diagnosis versus laser doppler image in predicting spontaneous burn wound healing. Results Comparing partial thickness burn injuries, there were 38 clinically diagnosed partial thickness injuries (by experienced burn providers) and 38 partial thickness burn injures diagnosed via LDI. Deep partial thickness burn injuries were diagnosed clinically in 9 subjects, compared to 10 via LDI. Full thickness burn injuries were diagnosed clinically in 7 subjects and 6 via LDI. A chi-square test was performed to examine the relationship between clinical diagnosis of burn depth and laser doppler image. The relation between these variables was significant,X2= 26.884, p< .000. Comparing clinically diagnosed burn depth to LDI, each approach (clinical or LDI) diagnosed 42 subjects with partial thickness or deep partial thickness burn injuries and all healed spontaneously. Two of the clinically diagnosed full thickness burn injuries required skin grafting. Six patients were lost to follow-up (X2= 17.745, p < .001). Conclusions This study confirms there is no difference between an experienced burn provider’s clinical diagnosis of burn wound depth and prognosis for spontaneous healing compared to a laser doppler image prognosis of burn wound healing. Applicability of Research to Practice In an era of advanced technologies, expert clinical bedside assessment is the standard of care.
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Farazin, Ashkan, Zahra Torkpour, Shakiba Dehghani, Ramin Mohammadi, Mina D. Fahmy, Saeed Saber-Samandari, Kirollos Adel Labib, and Amirsalar Khandan. "A Review on Polymeric Wound Dress for the Treatment of Burns and Diabetic Wounds." International Journal of Basic Science in Medicine 6, no. 2 (July 10, 2021): 44–50. http://dx.doi.org/10.34172/ijbsm.2021.08.
Анотація:
Today, various commercial dressings have been developed and introduced to the market. The diversity makes it difficult for the nurse to choose the right type. Although the most important reason to use a wound dress is to protect the wound from infection and prevent infection, but in fact, the main purpose of using these materials is to speed up the wound healing process. Traumatic injuries result in an epithelial wound that disrupts the continuity of the skin surface. These differences reveal as abrasions, punctures, and injuries. Wounds are divided into two types; the skin is either cut or ruptured, including deep wounds and bruises, or surface wounds. Expedited wound healing has been considered since the archaic era of human civilization, with the earliest reported case from the Ancient Egyptians. Wound lesions in mummified humans were observed to be cover with animal skin, with signs of (primary/secondary) wound healing present. A "new wound dressing" is an advanced wound dress used in wound management as biocompatible and biodegradable biomaterials that heal wounds and burns. In the past, it was believed that dry wounds had expedited healing and wet wounds have been found to promote using re-epithelization and result in reduced scar formation. Wounds can be treated using various types of natural polymers and materials. Also, techniques like electrospinning and freeze-drying techniques can be used for the fabrication of standard wound dress. These wounds are associated with bandages, inflammation, bleeding, pain, and pus. In this work, we consider various types of wounds and techniques to treat the wound. Susceptibility to these areas, due to special symptoms for each of them. Products like hydrogels, hydrocolloids, films, sponges, and nano-fiber polymeric materials are used to promote healing. In this review, we examine the ideal products for the treatment of wounds in diabetic patients.
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Grimell, Jan. "Veterans, the hidden wounds of war, and soul repair." Spiritual Care 7, no. 4 (October 8, 2018): 353–63. http://dx.doi.org/10.1515/spircare-2018-0008.
Анотація:
AbstractTo better understand how deployment in war zones and/or combat may inflict emotional wounds upon veterans, researchers, clinicians, and caregivers it was recently started to focus on the concepts of moral and spiritual injuries. Such injuries may remain undiscovered during psychiatric screening for posttraumatic stress disorder. What is often missing, however, is a conceptualization of the part of the self which is implicitly related to emotional wounds caused by moral and spiritual injuries. This article utilizes a number of historical and contemporary conceptualizations of what is called the soul, and their implications for pastoral and spiritual care of emotionally wounded veterans. Moreover, it explores the use of biblical stories in pastoral and spiritual care among veterans suffering from moral and spiritual injuries.
39
Kong, VY, GV Oosthuizen, and DL Clarke. "The spectrum of injuries resulting from posterior abdominal stab wounds: a South African experience." Annals of The Royal College of Surgeons of England 97, no. 4 (May 2015): 269–73. http://dx.doi.org/10.1308/003588415x14181254789204.
Анотація:
IntroductionThe spectrum of injury associated with anterior abdominal stab wounds (SWs) is well established. The literature on the spectrum of organ injury associated with SWs to the posterior abdomen, however, is limited.MethodsWe reviewed our experience of 105 consecutive patients who had established indications for laparotomy managed over a 4-year period in a high volume trauma service in South Africa.ResultsOf the 105 patients, 97 (92%) were male and the overall mean age was 24 years. Fifty-seven patients (54%) had immediate indications for laparotomy. The remaining 48 patients (46%) initially underwent active clinical observation and the indications for laparotomy became apparent during the observation period. Of the 105 laparotomies performed, 94 (90%) were positive and 11 (10%) were negative. Of the 94 positive laparotomies, 92 were therapeutic and 2 were non-therapeutic. A total of 176 organ injuries were identified: 50 (53%) of the 94 patients sustained a single organ injury while the remaining 44 (47%) sustained multiple organ injuries. The most commonly injured organs were the colon (n=63), spleen (n=21) and kidney (n=19).ConclusionsThe pattern of intra-abdominal injuries secondary to SWs to the posterior abdomen is different to that seen with the anterior abdomen. Colonic injury is most commonly encountered, followed by injuries to the spleen and kidney. Clinicians must remain vigilant because of the potential for occult injuries.
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Halfacree, Z. J., M. S. Tivers, and C. J. Jordan. "Airway injury associated with cervical bite wounds in dogs and cats: 56 cases." Veterinary and Comparative Orthopaedics and Traumatology 26, no. 02 (2013): 89–93. http://dx.doi.org/10.3415/vcot-12-01-0013.
Анотація:
Summary Objective: To investigate the frequency of airway injury and damage to other vital structures associated with cervical bite wounds in dogs and cats and the implications for management and outcome. Methods: A retrospective search of electronic patient records was used to identify dogs and cats suffering cervical bite wounds that were presented to a large multidisciplinary veterinary hospital over a four year period. Results: Complete records were available for 55 animals, with one animal suffering two separate injuries. Fourteen animals (25%) had injuries to vital structures, including airway injury in nine (17%) which was surgically confirmed and treated in six (11%). Airway injuries were associated with either subcutaneous or mediastinal emphysema in all affected animals. Other structures injured included the jugular vein, pharynx, oesophagus and spine. Airway injuries were treated with primary repair in five animals and a fasciomuscular patch in one. Temporary tracheostomy was performed in three animals. Median duration of hospitalisation was one day (0-19) with 53 animals (54 cases) (96%) surviving to discharge. Long-term follow-up (16-114 months) revealed that 43 of 49 animals were alive with six that died due to unrelated reasons. Clinical significance: Cervical bite wounds are associated with significant injury to vital structures. Up to 17% of animals may have injury to their airway. Identification and treatment of airway injury is vital and was associated with an excellent outcome in six animals.
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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.
Анотація:
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.
Анотація:
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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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.
Анотація:
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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Danchin, A. O., O. M. Goncharuk, M. S. Altabrowry, G. O. Danchin, S. A. Usatov, and O. P. Kovalenko. "Clinic and diagnostics of the non-penetrating gun-shoot craniocerebral injuries in the local war." Ukrainian Interventional Neuroradiology and Surgery 36, no. 2 (November 20, 2021): 34–43. http://dx.doi.org/10.26683/2786-4855-2021-2(36)-34-43.
Анотація:
Objective ‒ to evaluate the features of the clinical manifestations and effectiveness of multi-slice computed tomography (MSCT) of the head for the diagnosis of non-penetrating gun-shoot head injuries in the local war.Materials and methods. The medical data of 155 patients who received a non-penetrating gun-shoot head injuries during the war in the Eastern Ukraine between 2014‒2020 were analyzed. All patients were males between 18 and 60 years (average age ‒ 35.1 years). The peculiarities of clinical manifestations and results of diagnostic evaluation of non-penetrating gun-shoot head injuries during specialized neurosurgical care in medical institutions on the third and fourth levels of medical aid have been studied.Results. Wide diagnostic capabilities of MSCT were revealed for determination of the wounds localization, type of the projectile, the nature of the wound channel, gunshot skull fractures, and associated intracranial injuries. It was found that with non-penetrating bullet and shrapnel tangential cranio-cerebral wounds, incomplete and depressed fractures usually occurred, and with single and multiple shrapnel blind wounds, incomplete ‒ perforated and depressed fractures with the presence of bone fragments. The pathomorphological features of the nature of the wound channels and intracranial injuries were determined. They are always associated by traumatic subarachnoid hemorrhages and brain contusions, in most cases – focal. Intracranial hematomas were observed in 3.1 % of the patients.Conclusions. Clinical manifestations of the non-penetrating craniocerebral gunshot wounds depend not only on the type of cranial soft tissue injury, but also on the nature of the skull fracture and are mainly occurred because of the severity of the traumatic brain injury. MSCT of the head makes it possible to determine the localization of the wound, the type of the wounding projectile, the nature of the cranial soft tissues damage, wound channel, gunshot skull fractures and associated intracranial injuries.
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Low, Garren M. I., Kenji Inaba, Konstantinos Chouliaras, Bernardino Branco, Lydia Lam, Elizabeth Benjamin, Jay Menaker, and Demetrios Demetriades. "The Use of the Anatomic ‘Zones’ of the Neck in the Assessment of Penetrating Neck Injury." American Surgeon 80, no. 10 (October 2014): 970–74. http://dx.doi.org/10.1177/000313481408001013.
Анотація:
The traditional classification of neck injuries uses an anatomic description of Zones I through III. The objective of this article was to characterize the association between external wounds and the corresponding internal injuries after penetrating neck trauma to identify the clinical use of the anatomic zones of the neck. Patients who sustained penetrating neck trauma from December 2008 to March 2011 were analyzed. All patients underwent structured clinical examination documenting the external zone where the wound(s) were located. All internal injuries were then correlated with the external wounds. An internal injury was defined as “unexpected” if it was located outside the borders of the neck zone corresponding to the external wound. In total, 146 patients sustaining a penetrating neck injury were analyzed; 126 (86%) male. The mechanism of injury was stab wounds in 74 (51%) and gunshot wounds in 69 (47%). Mean age was 31 years (range, nine to 62 years). Thirty-seven (25%) patients sustained had a total of 50 internal injuries. There was a high incidence of noncorrelation between the location of the external injury and the internal structures that were damaged in patients with hard signs of vascular or aerodigestive injury. The use of the anatomic zones and their role in the workup of penetrating neck injury are questionable.
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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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Golub’, E. V., and A. P. Golub’. "TRAUMATIZATION BY LAMPREYS OF SOCKEYE SALMON ONCORHYNCHUS NERKA (WALBAUM, 1792) IN THE MEYNYPIL’GYN LAKE-RIVER SYSTEM (KORYAK COAST OF CHUKOTKA)." Izvestiya TINRO 198 (October 2, 2019): 3–18. http://dx.doi.org/10.26428/1606-9919-2019-198-3-18.
Анотація:
Data on traumatization of sockeye salmon Oncorhynchus nerka spawners in the Meynypil’gyn lake-river system by lampreys are presented on results of observations in 1998– 2018. Features and localization of injuries are described comparing the injuries of males and females and biological parameters of fish with and without the injuries. In the Meynypil’gyn lake-river system, relative to other areas of Russian Far East, the portion of fish with injuries from lampreys is medium for sockeye salmon, and low for pink salmon Oncorhynchus gorbuscha and charr Salvеlinus malma. Judging by size of the wounds, the injuries were caused mostly by arctic lamprey Entosphenus tridentatus. Generally, about 68 % of sockeye spawners were attacked by lampreys during their pre-spawning migrations just before entering the fresh waters, but the percentage (P) depends on length (L) of fish: P = 1.2026 . L + 1.2192 (R2 = 0.879). So, the portion of injured fish increased from 2.7 % for the sockeye producers with length < 500 mm to 31.2 % for those with length 671–680 mm. Mean size and weight of the male and female sockeye spawners with traces of lampreys were statistically significantly higher than these parameters for the fish without injuries. The males injured by lampreys were larger than the males without injures in 18 mm and 295 g, the females — in 5 mm and 80 g, on average. Sockeye females had weaker and less numerous damages, so their portion among the fish with 1 injury was 45.4 %, among the fish with 2 injuries — 42.9 %, among the fish with 3 or more injures — 37.0 %. Besides, mean size of the injured sockeye increased with a number of injures and for the groups with 1, 2, and 3 or more injures it was for females: 604, 608, and 613 mm, for males: 655, 667, and 674 mm, respectively. Such dependencies of alive fish traumatization on their size are caused by higher mortality of small fish after lampreys attacks. There is concluded that arctic lamprey affects significantly on sexual and size composition of sockeye spawners in the Meynypil’gyn lake-river system providing selection of fish with larger size and weight, in particular males.
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Jeong, Yeonjin, Sang-Yeul Lee, and Kun-Yong Sung. "Adjuvant Role of Botulinum Toxin A in the Management of Wounds Accompanied by Parotid Gland or Duct Injuries." Journal of Wound Management and Research 17, no. 1 (February 28, 2021): 24–29. http://dx.doi.org/10.22467/jwmr.2020.01438.
Анотація:
Background: Parotid gland or duct injuries may occur after facial trauma or surgical procedures around the parotid gland. Such injuries often cause saliva to leak into the wound, and as a result, the autolytic enzymes in the saliva can delay wound healing. To promote wound healing in such cases, salivary leakage must be stopped until the wound has completely healed. Though there are several known measures for preventing salivary leakage, including compressive dressings, suction drainage, food restriction, and anticholinergic drugs, they often yield unsatisfactory results. This study aimed to evaluate the clinical efficacy of botulinum toxin A in stopping salivary secretions and inducing wound healing in wounds accompanied by parotid gland or duct injuries.<br/>Methods: A retrospective study was conducted to evaluate the efficacy of botulinum toxin A for treating salivary leakage due to parotid gland or duct injuries. Five patients were treated between 2011 and 2016, three of whom received postoperative injections with a total dose of 30–40 units of botulinum toxin A. One of the other two patients was injected with the same amount of botulinum toxin A preoperatively, and the other received an intraoperative injection.<br/>Results: All five patients showed an abrupt decrease of salivary leakage on the 3rd day after toxin injection and satisfactory wound healing without untoward side effects.<br/>Conclusion: This study demonstrates the critical role played by botulinum toxin A in management of wounds complicated by abnormal leakage of saliva, when the parotid gland or duct is injured.
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Irfan-maqsood, Muhammad. "Classification of Wounds: Know before Research and Clinical Practice." Journal of Genes and Cells 4 (January 15, 2018): 1. http://dx.doi.org/10.15562/gnc.61.
Анотація:
Cutaneous wounds are known as the damages and injuries on the skin. Knowing the type of wound is very important before any kind of treatment or therapy being applied. Each type of wound is different from other due to the different structure, biology and pathophysiology, therefore, a kind of treatment for one wound cannot be specified for others. Considering the importance of types of wounds, these wounds are classified into different categories because of their different pathobiology. This manuscript would be a great piece of knowledge for the tissue engineer to develop specific skin substitute for specific wound which might help for the development of appropriate treatment strategies.