Penetrating trauma to the junctional zone needs aggressive management

Ahmad, Jubayer; Beattie, G. C.; Kennedy, Robert H.; Kennedy, J A; Clements, W. D. B.

doi:10.1136/bmj.39055.459248.80

Cited by 5 publications

(4 citation statements)

References 8 publications

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“…In junctional injuries (of the proximal thigh and groin, proximal arm and axilla) and those in the neck, it is not possible to use a tourniquet: immediate control is obtained by packing and direct pressure on the wounds. 12 These injuries are uncommon from blunt trauma in civilian practice but are seen as a result of gunshot wounds and, most frequently, on the battlefield. A number of external clotting agents have been introduced over the last few years and are used as haemostatic dressings.…”

Section: Circulationmentioning

confidence: 99%

“…For penetrating injuries with uncontrolled haemorrhage and persistent hypotension, rapid surgical control is life-saving. 12 Most cases will involve the torso, and the decision to transfer the patient to theatre immediately will be made by the general surgeons and the leader of the trauma team. Under these circumstances the patient should be transferred to the operating theatre within 20 minutes of arrival in the emergency department.…”

Section: Permissive Hypotensionmentioning

confidence: 99%

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The early management of patients with multiple injuries

Forward

2012

The Journal of Bone and Joint Surgery. British volume

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There have been many advances in the resuscitation and early management of patients with severe injuries during the last decade. These have come about as a result of the reorganisation of civilian trauma services in countries such as Germany, Australia and the United States, where the development of trauma systems has allowed a concentration of expertise and research. The continuing conflicts in the Middle East have also generated a significant increase in expertise in the management of severe injuries, and soldiers now survive injuries that would have been fatal in previous wars. This military experience is being translated into civilian practice. The aim of this paper is to give orthopaedic surgeons a practical, evidence-based guide to the current management of patients with severe, multiple injuries. It must be emphasised that this depends upon the expertise, experience and facilities available within the local health-care system, and that the proposed guidelines will inevitably have to be adapted to suit the local resources.

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Section: Circulationmentioning

confidence: 99%

Section: Permissive Hypotensionmentioning

confidence: 99%

The early management of patients with multiple injuries

Forward

2012

The Journal of Bone and Joint Surgery. British volume

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“…Unrecognised diaphragmatic injury after ballistic trauma may lead to herniation, which is often diagnosed late, sometimes with catastrophic consequences [54,55]. Laparoscopic examination (which may be more applicable after stab wounds rather than ballistic injuries) or laparotomy is therefore advisable when diaphragmatic injury is suspected, and there are no other indications for laparotomy or thoracotomy [19,[56][57][58].…”

Section: Suspected Ballistic Left Diaphragmatic Injury In the Absencmentioning

confidence: 99%

Selective Non-Operative Management of Abdominal Injury in the Military Setting

Jansen

2011

J R Army Med Corps

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“…Thoracoscopic procedures in a trained allow alternate access to the thoracic cavity for the treatment of multiple traumatic pathologies. The use of thoracoscopy in thoracic trauma is well supported in the literature as long as the patient is hemodynamically stable, allowing not only the diagnosis and treatment of patients with diaphragmatic injury thoracoabdominal trauma, but also the diagnosis and treatment of lesions in the chest wall, lung, heart, mediastinum and hemothorax drain, providing a low rate of complications and morbidity of minimally invasive surgery [9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Thoracoscopy and Massive Hemothorax in Hemodynamically Stable Patients

B¹

2013

J Trauma Treat

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Results45 patients were included in the study. 24 patients approached by thoracoscopy and thoracotomy 21. We found that 42 patients (93.3%) were male and three patients (6.7%) women with an age range between 13 and 55 years with a mean of 26,6 years.The mechanism of trauma in 43 patients (95.6%) were injured by sharp weapon and in two patients (4.4%) injured by gun fire to which Abstract Background: This study compares patient operated by thoracoscopy and thoracotomy in patients with penetrating chest wounds with massive hemothorax, hemodynamically stable. Materials and methods:Retrospective study Cross sectional, type III level of evidence.45 patients were included in the study. In 24 of them were approached by thoracoscopy and the remaining 21 by thoracotomy and compared morbidity, hospital stay, operative time, complications and conversion rate in patients with penetrating trauma massive hemothorax managed by thoracotomy hemodynamically stable with those managed by thoracoscopy during the period from Results: Thoracoscopy is associated with reduced blood loss, less operative time, shorter hospital stay by filing a conversion rate of 12.5% video assisted surgery procedures and a lower rate of complications. Conclusions:Thoracoscopy represents a therapeutic option and a safe approach in the right hands to the chest injured patients with massive hemothorax, hemodynamically stable.

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Penetrating trauma to the junctional zone needs aggressive management

Cited by 5 publications

References 8 publications

The early management of patients with multiple injuries

The early management of patients with multiple injuries

Selective Non-Operative Management of Abdominal Injury in the Military Setting

Thoracoscopy and Massive Hemothorax in Hemodynamically Stable Patients

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