Journal of Trauma and Acute Care Surgery最新文献

{"title":"Morbidity and mortality associated with ischemia-reperfusion injury after prolonged tourniquet use: A wartime single-center treatment algorithm.","authors":"Vitalii Lukiianchuk, Oleksandr Linchevskyy, Warren C Dorlac, Rachel M Russo, Pamela B Andreatta, Shahram Aarabi, Sahil Patel, Frank K Butler, Travis M Polk, John B Holcomb","doi":"10.1097/TA.0000000000004677","DOIUrl":"https://doi.org/10.1097/TA.0000000000004677","url":null,"abstract":"<p><strong>Background: </strong>The evolving warfare tactics used by near-peer adversaries are expected to increase the incidence of severe extremity injuries and delayed evacuations. Initial reports from combat in Ukraine suggest high complication rates associated with prolonged tourniquet use. This study aimed to evaluate the systemic effects of limb reperfusion following tourniquet application lasting 4 hours or more in patients with isolated extremity injuries. Patients were treated according to an evidence-based protocol designed to mitigate ischemia-reperfusion injuries.</p><p><strong>Methods: </strong>This retrospective review was conducted at a forward surgical facility in Ukraine during combat operations from May 2023 to February 2024. Patients with tourniquets in place for at least 4 hours were included, while those with contraindications to limb salvage or significant confounding injuries were excluded. Short-term outcomes assessed included limb salvage, organ failure, and survival rates.</p><p><strong>Results: </strong>Of the 1,945 casualties screened, 90 (4.6%) met the inclusion criteria. After excluding 16 patients, outcomes were analyzed for 74 males, with an average age of 41.6 ± 8.5 years and a mean tourniquet duration of 7.1 ± 2.9 hours. Among these, 19 patients (25.67%) had vascular injuries, and compartment syndrome was present in all cases. Hemodialysis was required for 58 patients (70.8%), while 27 (36.3%) needed a delayed limb amputation, and 5 patients (6.7%) died. Patients requiring dialysis underwent an average of 3 ± 2 sessions to recover kidney function. Longer tourniquet times increased the need for dialysis, which increased the likelihood of patient death.</p><p><strong>Conclusion: </strong>We used a standardized ischemia-reperfusion algorithm to reduce the systemic effects of ischemia and reperfusion during attempts to salvage limbs following 4 hours or more of tourniquet time. Preliminary outcomes indicate that survival is probable, kidney function may improve with brief periods of dialysis, and limb salvage is possible in most cases.</p><p><strong>Level of evidence: </strong>Retrospective Cohort Study; Level V.</p>","PeriodicalId":17453,"journal":{"name":"Journal of Trauma and Acute Care Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Joint Trauma System: A critical lifeline facing an uncertain future.","authors":"Reynold Henry, Jennifer Gurney, Scott Armen, Christopher D Barrett, Brian Gavitt, Philbert Van, Daniel Lammers, John McClellan, Martin Schreiber","doi":"10.1097/TA.0000000000004688","DOIUrl":"https://doi.org/10.1097/TA.0000000000004688","url":null,"abstract":"<p><strong>Abstract: </strong>The Joint Trauma System (JTS) has become a cornerstone of modern trauma care, revolutionizing battlefield treatment and saving countless lives through standardized, evidence-based protocols. Its development and success are rooted in lessons learned from the wars in Iraq and Afghanistan, where fragmented systems were transformed into cohesive, high-performing networks. The JTS has influenced not only military but also civilian trauma care, fostering a symbiotic relationship that advances innovation across both sectors. Despite its proven effectiveness, a growing movement within the US military questions its relevance during peacetime, threatening its existence. This article examines the history, impact, and future of the JTS while emphasizing the critical need for civilian advocacy to preserve its role as a key enabler of military readiness and trauma care innovation.</p><p><strong>Level of evidence: </strong>Expert Opinion; Level V.</p>","PeriodicalId":17453,"journal":{"name":"Journal of Trauma and Acute Care Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Source control in intra-abdominal infections: What you need to know.","authors":"Federico Coccolini, Andrew W Kirkpatrick, Camilla Cremonini, Massimo Sartelli","doi":"10.1097/TA.0000000000004654","DOIUrl":"https://doi.org/10.1097/TA.0000000000004654","url":null,"abstract":"<p><strong>Abstract: </strong>Providing optimal source control (SC) for intra-abdominal sepsis (IAS) is a critically important surgical principle, yet one that remains nebulous in terms of strict definitions and required conduct. The entire concept of SC has evolved in the last decades. Contemporary SC is not only surgical but also embraces minimally invasive percutaneous and medical therapies. We propose that adequate SC has evolved from the mere anatomical control of enteric leakage, cleansing of obvious contaminants and necrosis, to a more comprehensive anatomo-phyiological-biochemical model. While any breaches in the integrity of the gastrointestinal tract should be addressed urgently, SC should ultimately aim to control the generation and propagation of systemic biomediators, bacterial toxins, and toxic catabolites that perpetuate multisystem organ failure and death. Much urgently needs to be learned to understand and hopefully mitigate the dysbiotic influences of IAS on the human microbiome. Finally, the therapy offered should always be individualized, recognizing patient's unique pathophysiology, clinical condition, comorbidities, and predeclared preferences regarding invasive therapies and life-support.</p>","PeriodicalId":17453,"journal":{"name":"Journal of Trauma and Acute Care Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computed tomography after an abdominal gunshot wound: Be careful not to be navel-gazing.","authors":"Évelyne Peroux, Yvain Goudard, Nicolas Cazes","doi":"10.1097/TA.0000000000004576","DOIUrl":"https://doi.org/10.1097/TA.0000000000004576","url":null,"abstract":"","PeriodicalId":17453,"journal":{"name":"Journal of Trauma and Acute Care Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An analysis of potential cervical spine clearance in children with computed tomography alone.","authors":"Katie W Russell, Anastasia M Kahan, R Scott Eldredge, Robert A Swendiman, Zachary J Kastenberg, Annika B Kay, John W Rampton, Kelly Huynh, Hsuan-Yu Wan, David S Morris, Rajiv R Iyer, Vijay M Ravindra, Douglas L Brockmeyer","doi":"10.1097/TA.0000000000004667","DOIUrl":"https://doi.org/10.1097/TA.0000000000004667","url":null,"abstract":"<p><strong>Introduction: </strong>Clearance of the pediatric cervical spine (CS) after trauma remains a challenge. While missing an injury is unacceptable, prolonged immobilization is also detrimental. We aimed to determine the sensitivity and negative predictive value of computed tomography (CT) for the identification of clinically significant cervical spine injuries (CSIs) in pediatric blunt trauma patients across a large health system. We hypothesized that CT would be highly sensitive for detecting CSIs across a diverse network of hospitals.</p><p><strong>Methods: </strong>A retrospective cohort study of pediatric patients younger than 18 years with trauma diagnosis codes who underwent CS imaging within 24 hours of presentation to an emergency department was conducted across a mixed adult and pediatric 23-hospital system from January 2012 through December 2023. A clinically significant CSI was defined as an injury requiring CS surgery or halo placement within 7 days of presentation. Patients who underwent CT and had a clinically significant CSI were compared with those without.</p><p><strong>Results: </strong>A total of 14,232 pediatric trauma patients were evaluated with CS CTs. An additional 10,900 with minor trauma were screened with x-ray and no CT. Of patients who underwent CT, 109 (0.8%) had CSIs. On univariate analysis, CSI patients were more likely to be obtunded shown by an increase in intubation (19% vs. 5%, p < 0.001), and a Glasgow Coma Scale score of <14 (22% vs. 6%, p = 0.049). Four patients with CSIs had normal CTs per initial radiographic report. Post hoc analysis by an expert spine panel identified abnormalities on all CTs. The sensitivity of CT for diagnosing CSI was 96%, and the negative predictive value was 100%. This was consistent across all age groups.</p><p><strong>Conclusion: </strong>Computed tomography has a high sensitivity for detecting clinically significant CSIs in pediatric trauma patients across all ages and a wide variety of hospitals. Consideration must be given to clearing the pediatric CS based on a negative CT in the absence of symptoms.</p><p><strong>Level of evidence: </strong>Retrospective Cohort Study; Level IV.</p>","PeriodicalId":17453,"journal":{"name":"Journal of Trauma and Acute Care Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does pediatric trauma center designation matter for children in shock from gunshot wounds? A Trauma Quality Improvement Program analysis.","authors":"Micaela K Gomez, Elizabeth C Wood, Maximilian Peter Forssten, Timothy K Williams, Sebastian Peter Forssten, Babak Sarani, Shahin Mohseni, Lucas P Neff","doi":"10.1097/TA.0000000000004637","DOIUrl":"https://doi.org/10.1097/TA.0000000000004637","url":null,"abstract":"<p><strong>Background: </strong>Recent studies have demonstrated improved outcomes for severely injured pediatric trauma patients treated at pediatric trauma centers (PTCs). Nonetheless, specific injury patterns requiring immediate lifesaving intervention may offset the recognized benefits of PTC over adult trauma centers (ATCs). This study aims to compare the clinical outcomes of hypotensive pediatric trauma patients with gunshot wounds (GSWs), based on trauma center type. We hypothesize that outcomes are equivalent for this clinical scenario.</p><p><strong>Methods: </strong>The 2013-2021 Trauma Quality Improvement Program data set was used to identify all hypotensive pediatric patients (15 years or younger) with GSWs. Hypotension was defined per Pediatric Advanced Life Support Guidelines. Patients with an Abbreviated Injury Scale score of 6 in any region and transferred patients were excluded. In order to identify the association between PTC verification status and outcomes, Poisson regression models with robust standard errors were used.</p><p><strong>Results: </strong>A total of 687 patients met the criteria for analysis, and 236 (34%) cases were treated at PTCs. Pediatric trauma center patients were slightly younger (lower quartile, 10 vs. 12 years old; p = 0.037). There was no significant difference in Injury Severity Score or crude mortality rates (68.1% vs. 70.8%, p = 0.524). After adjusting for confounders, Poisson regression showed no reduction in in-hospital mortality, complications, failure to rescue, intensive care unit admission, or mechanical ventilation rates at PTCs compared with ATCs.</p><p><strong>Conclusion: </strong>Gunshot wounds in children pose unique clinical challenges. Majority of cases are cared for at ATCs. Analysis of best available data did not demonstrate a benefit to managing these patients at a PTC. Conversely, ATCs were not superior, despite managing this scenario in both adults and children more often. These findings underscore the importance of ATCs in the care of this particular injury pattern and call attention to the recent pediatric readiness requirements for American College of Surgeons (ACS)-verified trauma centers to treat pediatric firearm injuries at both PTCs and ATC.</p><p><strong>Level of evidence: </strong>Therapeutic/Care Management; Level III.</p>","PeriodicalId":17453,"journal":{"name":"Journal of Trauma and Acute Care Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Elevated cell-free hemoglobin: A novel early biomarker following traumatic injury.","authors":"İbrahim Eker, Soner Yılmaz, Aytekin Ünlü","doi":"10.1097/TA.0000000000004636","DOIUrl":"https://doi.org/10.1097/TA.0000000000004636","url":null,"abstract":"","PeriodicalId":17453,"journal":{"name":"Journal of Trauma and Acute Care Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time-limited association between plasma transfusion and mortality in pediatric traumatic brain injury.","authors":"Leah Furman, Erin V Feeney, Barbara A Gaines, Christine M Leeper","doi":"10.1097/TA.0000000000004694","DOIUrl":"https://doi.org/10.1097/TA.0000000000004694","url":null,"abstract":"<p><strong>Background: </strong>Traumatic brain injury (TBI) is a predominant cause of pediatric mortality. While prehospital plasma administration has been associated with lower mortality in adults with TBI, the impact of early plasma in children is unknown.</p><p><strong>Methods: </strong>In this retrospective cohort study, we examined the impact of plasma transfusion within 4 hours of arrival on 4-hour, 24-hour, and 30-day mortality in children aged 1 to 17 years with severe TBI (head Abbreviated Injury Scale scores 4 and 5) using the National Trauma Data Bank from 2020 to 2022. We excluded subjects with mild-moderate or nonsurvivable TBI or missing plasma or weight data. Cox proportional hazard models, clustered by facility, assessed the effect of early plasma on mortality, adjusting for: age; sex; trauma mechanism; interfacility transfer; shock; total Glasgow Coma Scale; Injury Severity Score; trauma center level; insurance; binary whole blood, red blood cell, and platelet administration; and weight-adjusted total 4-hour transfusion volumes.</p><p><strong>Results: </strong>Of 367,065 children in the National Trauma Data Bank from 2020 to 2022, 14,691 met the inclusion criteria, of whom 1,594 (10.9%) received early plasma. Subjects were mostly male (67.8%), with a median (interquartile range) age of 12 (5-15) years, Glasgow Coma Scale score of 11 (3-15), Injury Severity Score of 25 (17-29), and 28.7% presenting in shock. The adjusted hazard ratio (HR) for the effect of plasma administration on mortality was 0.610 (95% CI, 0.430-0.864; p = 0.005) at 4 hours, 0.894 (95% CI, 0.706-1.131; p = 0.350) at 24 hours, and 1.132 (95% CI, 0.961-1.334; p = 0.138) at 30 days.</p><p><strong>Conclusion: </strong>This study reports a significant association between early plasma administration and a lower risk of 4-hour mortality among children with severe TBI that does not persist at or beyond 24 hours. While these data suggest that plasma resuscitation may extend the window for lifesaving intervention, additional prospective data are needed.</p><p><strong>Level of evidence: </strong>Therapeutic/Care Management; Level III.</p>","PeriodicalId":17453,"journal":{"name":"Journal of Trauma and Acute Care Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review and meta-analysis of efficacy of helmet use and helmet laws to reduce mortality and cervical spine injury in adult motorcycle riders: A practice management guideline from the Eastern Association for the Surgery of Trauma.","authors":"Asanthi M Ratnasekera, Sirivan S Seng, Stuart K Gardiner, Caroline Butler, Anna Goldenberg-Sandau, Ning Lu, Hiba Abdel Aziz, Rachel D Appelbaum, Hassan Mashbari, Shabnam Hafiz, Sharfuddin Chowdhury, Hahn Soe-Lin, John M Reynolds, Amanda L Teichman, Susan Kartiko, Elinore J Kaufman, Patrick Murphy, Lisa Kodadek, Rishi Rattan","doi":"10.1097/TA.0000000000004607","DOIUrl":"10.1097/TA.0000000000004607","url":null,"abstract":"<p><strong>Background: </strong>Motorcycle crash fatalities remain a significant public health concern. Traumatic brain injury is a leading cause of death following motorcycle crash. We aim to provide evidence-based guidelines pertaining to helmet use and helmet laws with respect to important outcomes including mortality, cervical spine injury, and discharge disposition.</p><p><strong>Methods: </strong>An evidence-based systematic review was performed to answer the following Population, Intervention, Comparator, Outcomes (PICO) questions: PICO 1-Should adult motorcycle riders wear helmets or not wear helmets to improve mortality, brain injury-related mortality, cervical spine injury, and discharge disposition from the hospital? PICO 2-Should motorcycle universal helmet laws (UHLs) or no UHLs be enacted to improve mortality, brain injury-related mortality, cervical spine injury, and discharge disposition from the hospital? An academic medical librarian searched Medline, Cochrane CENTRAL, CINAHL, Embase, Engineering Village, Health and Safety Science Abstracts, Scopus, SPORTDiscus, TRID, the VHL Regional Portal, and Elsevier. The Grading of Recommendations Assessment, Development, and Evaluation methodology was used to assess the quality of the evidence and create recommendations. The working group reached consensus on the final evidence-based recommendations. The study was registered in PROSPERO (CRD42020172705).</p><p><strong>Results: </strong>A total of 28 studies were identified for analysis for PICO 1, and 10 studies were identified for PICO 2. Helmet use was associated with a lower incidence of mortality (odds ratio, 0.48; 95% confidence interval, 0.41-0.56; p < 0.001) and lower incidence of cervical spine injury (odds ratio, 0.66; 95% confidence interval, 0.58-0.76; p < 0.001). Although a meta-analysis for PICO 2 was not possible because of significant methodological heterogeneity, the vast majority of studies demonstrated large improvements in outcomes with a UHL. Overall certainty of evidence was deemed low for PICO 1 and PICO 2 because of risk of bias.</p><p><strong>Conclusion: </strong>We strongly recommend that individual motorcycle riders wear helmets and that universal helmet legislation be enacted and enforced to decrease mortality, to decrease the incidence of cervical spine injury, and to improve discharge disposition from the hospital.</p><p><strong>Level of evidence: </strong>Systematic Review and Meta-analysis; Level II.</p>","PeriodicalId":17453,"journal":{"name":"Journal of Trauma and Acute Care Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical and pharmacostability of 15 essential medications in cold and ultracold environments.","authors":"Jason McMullan, Christopher Droege, Thomas Blakeman, John-Michael Fowler, Eric Mueller, Maia Smith, Madeline Foertsch","doi":"10.1097/TA.0000000000004648","DOIUrl":"https://doi.org/10.1097/TA.0000000000004648","url":null,"abstract":"<p><strong>Background: </strong>Medications require storage and use at room temperature but are largely untested in extreme temperature environments. Deep freezing and frequent freeze-thaw cycling may be expected in Artic and Polar missions. We hypothesize that medications have variable tolerance to exposure of up to 90 days of deep freezing or freeze-thaw cycling.</p><p><strong>Methods: </strong>With military stakeholder input, 15 essential medications were placed in programmed environmental chambers to maintain -60°F (-51°C, deep freeze) or cycle between 12 hours at -40°F (-40°C) and 68°F (20°C), mimicking possible operational scenarios. Controls were stored at room temperature. Six vials of each medication were placed in each environment for 30, 60, and 90 days of exposure. After exposure, each vial was examined for physical/visual abnormality and sent for concentration testing via high-performance liquid chromatography. Changes from labeled concentration >10% were considered significant, consistent with Food and Drug Administration guidance.</p><p><strong>Results: </strong>Amiodarone, phenylephrine, norepinephrine, haloperidol, dexamethasone, rocuronium, and metoprolol show physical and pharmacostability through 90 days in both environments. Propofol shows disruption of the emulsion and significant degradation after 30 days in both environments. Sodium bicarbonate, tranexamic acid, calcium chloride, and succinylcholine vials frequently shattered by 30 days of exposure. One naloxone vial experienced degradation. At 30 days, all epinephrine vials had physical change with separation of protective caps from the vials, and two had breakage; unbroken vials showed no degradation in either environment. Atropine experienced limited breakage and no degradation.</p><p><strong>Conclusion: </strong>Some critical medications experience physical failure and chemical degradation when exposed to up to 90 days of deep freeze or freeze-thaw cycles. Studied formulations of propofol, tranexamic acid, epinephrine, calcium chloride, succinylcholine, and sodium bicarbonate should not be deployed unless these temperature extremes can be avoided. Alternative formulations, packaging, and environmental mitigation solutions should be considered.</p>","PeriodicalId":17453,"journal":{"name":"Journal of Trauma and Acute Care Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}