General Surgery & Trauma
Pre-post study | Effects of a standardized perioperative management protocol in acute abdominal surgery
5 May, 2023 | 15:10h | UTC
RCT | Craniotomy and decompressive craniectomy yield comparable outcomes in acute subdural hematoma
2 May, 2023 | 13:51h | UTCDecompressive Craniectomy versus Craniotomy for Acute Subdural Hematoma – New England Journal of Medicine (link to abstract – $ for full-text)
News Release: International study recommends replacing skull section after treatment for a brain bleed – University of Cambridge
Commentary on Twitter
Presented at #AANS2023: In an international trial involving 450 patients with acute subdural hematoma, craniotomy (replacing bone flap) and decompressive craniectomy (removing bone flap) yielded similar disability results at 12 months. https://t.co/KoNebwQIsi#neurosurgery pic.twitter.com/t9E9YZeHyq
— NEJM (@NEJM) April 23, 2023
RCT | The effectiveness of early surgical stabilization for multiple rib fractures
26 Apr, 2023 | 14:01h | UTCRelated:
RCT | Operative vs. nonoperative treatment of acute unstable chest wall injuries.
RCT | Rib fixation is not beneficial for non–ventilator-dependent chest wall injuries.
Pro-Con Debate | Peripheral nerve blockade should be provided routinely in extremity trauma
25 Apr, 2023 | 14:31h | UTCPro-Con Debate: Peripheral Nerve Blockade Should Be Provided Routinely in Extremity Trauma, Including in Patients At Risk for Acute Compartment Syndrome – Anesthesia & Analgesia (free for a limited period)
Prehospital guidelines for the management of traumatic brain injury
24 Apr, 2023 | 13:45h | UTC
Cohort Study | Prehospital end-tidal CO2 levels and mortality in suspected severe traumatic brain injury patients
24 Apr, 2023 | 13:35h | UTCEditorial: Prehospital ventilation targets in severe traumatic brain injury – Intensive Care Medicine
Commentary on Twitter
Prehospital etCO2 in severe #TBI, BRAIN-PROTECT study
🚁 L-shaped association with mortality
🧠 35-45 mmHg seems reasonable target: lower ETCO2? sharp mortality ⬆️
🖇️ https://t.co/DC0DoHa00NWith editorial on MV targets & reliability of available data
🖇️ https://t.co/jVZ4zZVHxv pic.twitter.com/74vKxjyGpA— Intensive Care Medicine (@yourICM) April 20, 2023
RCT | Peri-intubation hypoxia after delayed vs. rapid sequence intubation in critically injured patients on arrival to trauma triage
24 Apr, 2023 | 13:04h | UTCPeri-Intubation Hypoxia After Delayed Versus Rapid Sequence Intubation in Critically Injured Patients on Arrival to Trauma Triage: A Randomized Controlled Trial – Anesthesia & Analgesia (link to abstract – $ for full-text)
Review | The management of pregnant trauma patients
24 Apr, 2023 | 13:01h | UTCThe Management of Pregnant Trauma Patients: A Narrative Review – Anesthesia & Analgesia (free for a limited period)
See also: Infographic (free for a limited period)
RCT | Effectiveness of nail bed repair in children with vs. without replacing the fingernail
4 Apr, 2023 | 13:33h | UTCNews Release: New approach to nail bed injury surgery could significantly cut NHS costs – University of Oxford
Review | Acute respiratory distress syndrome, mechanical ventilation, and inhalation injury in burn patients
3 Apr, 2023 | 13:38h | UTC
M-A | Incidence of multiple organ failure in adult polytrauma patients
30 Mar, 2023 | 13:30h | UTC
Practice Guidance | On-site treatment of avalanche victims
28 Mar, 2023 | 14:48h | UTC
Position Paper | Prehospital hemorrhage control and treatment by clinicians
27 Mar, 2023 | 13:20h | UTC
Phase 2b RCT | Efficacy and safety of PL-5 (Peceleganan) spray for wound infections
27 Mar, 2023 | 13:08h | UTC
Cohort Study | Association between motor vehicle crashes and adverse maternal outcomes in pregnancy
24 Mar, 2023 | 12:54h | UTCMaternal outcomes in association with motor vehicle crashes during pregnancy: a nationwide population-based retrospective study – Injury Prevention (link to abstract – full text may be available here)
News Release: Pregnant women in traffic collisions at heightened risk of birth complications – BMJ Newsroom
M-A | Efficacy of intraosseous access for trauma resuscitation
23 Mar, 2023 | 12:52h | UTC
RCT | 4F-PCC fails to reduce blood product consumption and raises thromboembolic events in trauma patients
22 Mar, 2023 | 13:41h | UTCSummary: The PROCOAG Randomized Clinical Trial aimed to investigate the efficacy and safety of 4-factor prothrombin complex concentrate (4F-PCC) in trauma patients at risk of massive transfusion. Conducted in 12 French trauma centers, this double-blind, randomized, placebo-controlled superiority trial involved 324 patients. All patients were treated according to European traumatic hemorrhage guidelines and received early ratio-based transfusion (packed red blood cells:fresh frozen plasma ratio of 1:1 to 2:1). The primary outcome measured was 24-hour blood product consumption (efficacy), while arterial or venous thromboembolic events were assessed as a secondary outcome (safety).
The trial revealed no significant difference in 24-hour blood product consumption between the 4F-PCC and placebo groups, with median consumption of 12 units and 11 units, respectively. However, the study identified a statistically significant higher risk of thromboembolic events in the 4F-PCC group, with 35% of patients experiencing at least one event compared to 24% in the placebo group.
In conclusion, the study found no beneficial effect of incorporating 4F-PCC into a ratio-based transfusion strategy for patients with severe trauma at risk of massive transfusion. Furthermore, the higher rate of thromboembolic events in the 4F-PCC group indicated potential harm. The findings do not support the routine use of 4F-PCC in patients experiencing trauma who are at risk for extensive transfusion.
Article: Efficacy and Safety of Early Administration of 4-Factor Prothrombin Complex Concentrate in Patients With Trauma at Risk of Massive Transfusion: The PROCOAG Randomized Clinical Trial – JAMA (free for a limited period)
See also: Visual Abstract
Review | Neurogenic shock: definition, identification, and management in the ED
20 Mar, 2023 | 13:09h | UTCNeurogenic Shock: Definition, Identification, and Management in the ED – emDocs
Review | Approach to the patient with adrenal hemorrhage
15 Mar, 2023 | 15:03h | UTCApproach to the Patient With Adrenal Hemorrhage – The Journal of Clinical Endocrinology & Metabolism
Brief Review | Enhanced recovery after emergency laparotomy
13 Mar, 2023 | 14:37h | UTCEnhanced recovery after emergency laparotomy – British Journal of Surgery
New WHO guidelines to boost the use of life-saving safety restraints in vehicles
10 Mar, 2023 | 14:40h | UTCNews Release: New global guidelines to boost the use of life-saving safety restraints in vehicles – World Health Organization
Perspective | Dangerous selfies aren’t just foolish. We need to treat them like the public health hazard they really are
8 Mar, 2023 | 14:30h | UTC
E-Scooter users more likely to suffer serious trauma compared to bicycle users: a nationwide study in England and Wales
8 Mar, 2023 | 14:13h | UTCSummary:
The study aimed to determine the incidence, demographics, and injury patterns involved in E-Scooter-related hospital admissions due to significant trauma compared with bicycle-related trauma within England and Wales. The retrospective cohort study was based on data submitted to the UK Trauma Audit and Research Network (TARN) registry between 1 January 2021 to 31 December 2021.
The study found that E-Scooter users were more likely to be admitted to a major trauma center or a critical care unit than bicycle users. Serious head and limb trauma occurred more frequently among E-Scooter users, while serious chest and pelvic trauma were greater among bicycle users. Over one-third of E-Scooter injuries were incurred outside the current legislation by patients who were intoxicated by alcohol and drugs or under the age of 17.
The study suggests a greater relative incidence of serious trauma and an alternative pattern of injury among E-Scooter users compared with bicycle users. The study concludes that further legislation and tighter regulation of E-Scooter rental are required to reduce the already significant burden of injury associated with this mode of transport.
Article: Major trauma among E-Scooter and bicycle users: a nationwide cohort study – Injury Prevention
News Release: Crashing an e-scooter likely to lead to more serious injuries than crashing a bike – British Medical Journal
Commentary: E-scooter riders more likely than cyclists to sustain serious injuries – BBC
The European guideline on management of major bleeding and coagulopathy following trauma
2 Mar, 2023 | 13:04h | UTC
Guidelines | Efficacy and safety of non-steroidal anti-inflammatory drugs for the treatment of acute pain after orthopedic trauma
28 Feb, 2023 | 13:48h | UTC