Trauma Surgery & Acute Care Open最新文献

{"title":"Patient education series: exploratory laparotomy.","authors":"Aimee LaRiccia, Caitlin Anne Fitzgerald","doi":"10.1136/tsaco-2024-001685","DOIUrl":"https://doi.org/10.1136/tsaco-2024-001685","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001685"},"PeriodicalIF":2.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed fascial closure for prolonged open abdomen.","authors":"Taiki Yamataka, Shokei Matsumoto, Masayuki Shimizu","doi":"10.1136/tsaco-2024-001524","DOIUrl":"https://doi.org/10.1136/tsaco-2024-001524","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001524"},"PeriodicalIF":2.1,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic versus Laparoscopic Emergency and Acute Care Surgery: Redefining Novelty (RLEARN): feasibility and benefit of robotic cholecystectomy for acute cholecystitis at a level 1 trauma center.","authors":"Joshua Klein, Mekedes Lemma, Kartik Prabhakaran, Aryan Rafieezadeh, Jordan Michael Kirsch, Gabriel Rodriguez, Ilyse Blazar, Anna Jose, Bardiya Zangbar","doi":"10.1136/tsaco-2024-001522","DOIUrl":"10.1136/tsaco-2024-001522","url":null,"abstract":"<p><strong>Background: </strong>This study aims to compare outcomes of robotic cholecystectomy (RC) versus laparoscopic cholecystectomy (LC) in the setting of a level 1 trauma center.</p><p><strong>Methods: </strong>We performed a retrospective study of our hospital data (2021-2024) on patients who underwent LC or RC. Using a previously validated intraoperative grading system, four grades of cholecystitis were defined as mild (A), moderate (B), severe (C), and extreme (D). Outcomes were operative times and rates of conversion to open surgery.</p><p><strong>Results: </strong>In total, 260 patients (n=130 RC and n=130 LC) were included. Patients were primarily female (69.2%), with mean age of 47±18.3 years. The majority of cases had grade B cholecystitis (41.2%). Patients undergoing RC had lower operative times compared with LC in grade B (101.87±17.54 vs 114.96±29.44 min, p=0.003) and grade C (134.68±26.97 vs 152.06±31.3 min, p=0.038). Conversion rate to open cholecystectomy were similar in both groups (p=0.19).</p><p><strong>Conclusion: </strong>RC had similar results as LC in terms of operative time and in fact has significantly lower operative time in patients with grade B and grade C cholecystitis.</p><p><strong>Level of evidence: </strong>Level III-retrospective study.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001522"},"PeriodicalIF":2.1,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trauma-informed language as a tool for health equity.","authors":"Lucy Hart, John N Bliton, Christine Castater, Jessica H Beard, Randi N Smith","doi":"10.1136/tsaco-2024-001558","DOIUrl":"10.1136/tsaco-2024-001558","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001558"},"PeriodicalIF":2.1,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreaticoduodenectomy in trauma patients with grade IV-V duodenal or pancreatic injuries: a post hoc analysis of an EAST multicenter trial.","authors":"Rachel Leah Choron, Charoo Piplani, Julia Kuzinar, Amanda L Teichman, Christopher Bargoud, Jason D Sciarretta, Randi N Smith, Dustin Hanos, Iman N Afif, Jessica H Beard, Navpreet Kaur Dhillon, Ashling Zhang, Mira Ghneim, Rebekah Devasahayam, Oliver Gunter, Alison A Smith, Brandi Sun, Chloe S Cao, Jessica K Reynolds, Lauren A Hilt, Daniel N Holena, Grace Chang, Meghan Jonikas, Karla Echeverria-Rosario, Nathaniel S Fung, Aaron Anderson, Caitlin A Fitzgerald, Ryan Peter Dumas, Jeremy H Levin, Christine T Trankiem, JaeHee Yoon, Jacqueline Blank, Joshua P Hazelton, Christopher J McLaughlin, Rami Al-Aref, Jordan Michael Kirsch, Daniel S Howard, Dane R Scantling, Kate Dellonte, Michael A Vella, Brent Hopkins, Chloe Shell, Pascal Udekwu, Evan G Wong, Bellal Joseph, Howard Lieberman, Walter A Ramsey, Collin H Stewart, Claudia Alvarez, John D Berne, Jeffry Nahmias, Ivan Puente, Joe Patton, Ilya Rakitin, Lindsey Perea, Odessa Pulido, Hashim Ahmed, Jane Keating, Lisa M Kodadek, Jason Wade, Henry Reynold, Martin Schreiber, Andrew Benjamin, Abid Khan, Laura K Mann, Caleb Mentzer, Vasileios Mousafeiris, Francesk Mulita, Shari Reid-Gruner, Erica Sais, Christopher W Foote, Carlos H Palacio, Dias Argandykov, Haytham Kaafarani, Michelle T Bover Manderski, Lilamarie Moko, Mayur Narayan, Mark Seamon","doi":"10.1136/tsaco-2024-001438","DOIUrl":"10.1136/tsaco-2024-001438","url":null,"abstract":"<p><strong>Introduction: </strong>The utility of pancreaticoduodenectomy (PD) for high-grade traumatic injuries remains unclear and data surrounding its use are limited. We hypothesized that PD does not result in improved outcomes when compared with non-PD surgical management of grade IV-V pancreaticoduodenal injuries.</p><p><strong>Methods: </strong>This is a retrospective, multicenter analysis from 35 level 1 trauma centers from January 2010 to December 2020. Included patients were ≥15 years of age with the American Association for the Surgery of Trauma grade IV-V duodenal and/or pancreatic injuries. The study compared operative repair strategy: PD versus non-PD.</p><p><strong>Results: </strong>The sample (n=95) was young (26 years), male (82%), with predominantly penetrating injuries (76%). There was no difference in demographics, hemodynamics, or blood product requirement on presentation between PD (n=32) vs non-PD (n=63). Anatomically, PD patients had more grade V duodenal, grade V pancreatic, ampullary, and pancreatic ductal injuries compared with non-PD patients (all p<0.05). 43% of all grade V duodenal injuries and 40% of all grade V pancreatic injuries were still managed with non-PD. One-third of non-PD duodenal injuries were managed with primary repair alone. PD patients had more gastrointestinal (GI)-related complications, longer intensive care unit length of stay (LOS), and longer hospital LOS compared with non-PD (all p<0.05). There was no difference in mortality or readmission. Multivariable logistic regression analysis determined PD to be associated with a 3.8-fold greater odds of GI complication (p=0.010) compared with non-PD. In a subanalysis of patients without ampullary injuries (n=60), PD patients had more anastomotic leaks compared with the non-PD group (3 (30%) vs 2 (4%), p<i>=</i>0.028).</p><p><strong>Conclusion: </strong>While PD patients did not have worse hemodynamics or blood product requirements on admission, they sustained more complex anatomic injuries and had more GI complications and longer LOS than non-PD patients. We suggest that the role of PD should be limited to cases of massive destruction of the pancreatic head and ampullary complex, given the likely procedure-related morbidity and adverse outcomes when compared with non-PD management.</p><p><strong>Level of evidence: </strong>IV, Multicenter retrospective comparative study.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001438"},"PeriodicalIF":2.1,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Equitable and effective clinical guidance development and dissemination: trauma aims to lead the way.","authors":"Lacey N LaGrone, Deborah M Stein, Danielle J Wilson, Eileen M Bulger, Ashley Farley, Andrés M Rubiano, Maria Michaels, Meghan B Lane-Fall, Michael A Person, Vanessa P Ho, Linda Reinhart, Elliott R Haut","doi":"10.1136/tsaco-2023-001338","DOIUrl":"10.1136/tsaco-2023-001338","url":null,"abstract":"<p><p>Thirty-four per cent of deaths among Americans aged 1-46 are due to injury, and many of these deaths could be prevented if all hospitals performed as well as the highest-performing hospitals. The Institute of Medicine and the National Academies of Science, Engineering and Medicine have called for learning health systems, with emphasis on clinical practice guidelines (CPGs) as a means of limiting preventable deaths. Reduction in mortality has been demonstrated when evidence-based trauma CPGs are adhered to; however, guidelines are variably updated, redundant, absent, inaccessible, or perceived as irrelevant. Ultimately, these barriers result in poor guideline implementation and preventable patient deaths. This multidisciplinary group of injury providers, clinical guidance developers and end users, public health and health policy experts and implementation scientists propose key areas for consideration in the definition of an ideal future state for clinical guidance development and dissemination. Suggestions include (1): professional societies collaborate rather than compete for guideline development.(2) Design primary clinical research for implementation, and where relevant, with guideline development in mind.(3) Select clinical topics for guideline development through systematic prioritization, with an emphasis on patient-centered outcomes.(4) Develop guideline authorship groups with a focus on transparency, equity of opportunity and diversity of representation.(5) Establish a plan for regular review and updating and provide the date the guideline was last updated for transparency.(6) Integrate options for adapting the guideline to local resources and needs at the time of development.(7) Make guidelines available on a platform that allows for open feedback and utilization tracking.(8) Improve discoverability of guidelines.(9) Optimize user-experience with a focus on inclusion of bedside-ready, mobile-friendly infographics, tables or algorithms when feasible.(10) Use open access and open licenses.(11) Disseminate clinical guidance via comprehensive and equitable communication channels. Guidelines are key to improve patient outcomes. The proposed focus to ensure trauma guidelines are equitably and effectively developed and disseminated globally.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001338"},"PeriodicalIF":2.1,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitigating the risk of low-titer group O-positive whole blood resuscitation in females of childbearing potential: toward a systems-based approach.","authors":"Elizabeth P Crowe, Steven M Frank, Matthew J Levy","doi":"10.1136/tsaco-2024-001687","DOIUrl":"10.1136/tsaco-2024-001687","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001687"},"PeriodicalIF":2.1,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Not too short, not too long, but just right: does pre-arrival time impact team performance?","authors":"Jacob Schriner, Ryan Dumas","doi":"10.1136/tsaco-2024-001688","DOIUrl":"10.1136/tsaco-2024-001688","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001688"},"PeriodicalIF":2.1,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polytrauma patient with a massive pulmonary embolism and ischemic stroke in the setting of a patent foramen ovale.","authors":"Ibraheem Hamzat, Sabrina Wang, Samuel Osei, Takeyoshi Ota, David A Hampton","doi":"10.1136/tsaco-2024-001596","DOIUrl":"10.1136/tsaco-2024-001596","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001596"},"PeriodicalIF":2.1,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community of trauma care partnering with stakeholders to improve injury outcomes: survey analysis and panel development.","authors":"Rachel D Appelbaum, Anna B Newcomb, Michelle A Price, Katherine Joseph, Ashley N Moreno, Morgan Hennessy, Princess Fortin, Pam J Bixby, Sue Prentiss, Alexandra McConnell-Hill, Rochelle Flayter, Rochelle A Dicker, Rosemary A Kozar, Elliott R Haut, Deborah M Stein","doi":"10.1136/tsaco-2024-001466","DOIUrl":"10.1136/tsaco-2024-001466","url":null,"abstract":"<p><strong>Background: </strong>In June 2021, the Injury Research Engagement Project (I-REP) was established. In 2022, we preformed focus group analysis with patients/caregiver and researchers that resulted in themes in preferences, motivations, and best practices to increase participation in trauma research. The importance of trust and well-established relationships was common across all groups. In this study, we aimed to further evaluate preferences regarding research procedures and outcomes, and develop a panel for sustained patient engagement.</p><p><strong>Methods: </strong>We performed a multiphase, mixed methods study to elicit trauma stakeholders' perspectives regarding aspects of research. Previously published phase 1 involved focus group analysis. Phase 2 vignette-based surveys and phase 3 panel formation are described here. One survey was completed by patients/caregivers, and the second by trauma researchers. We compared the responses using independent t-tests. This was followed by a webinar and development of an I-REP panel of patients/caregivers.</p><p><strong>Results: </strong>60 patients/caregivers and 114 researchers participated in the online surveys, with completion rates of 68% and 69%, respectively. The majority of patients/caregivers were >45 years, female (66.7%), and >3 years out from their or their family member's injury (68.6%). The majority of the researchers were >35 years and male (56.2%). Participants were asked to gauge their perceptions of different research scenarios. The analysis identified themes emerging across groups. Several survey findings differed from phase 1, including motivations to participate (payment) and consent preferences (timing, approach). Racial and ethnic demographics of the participants were not collected.</p><p><strong>Conclusions: </strong>Engaging trauma stakeholders results in research more relevant to patients' needs and priorities. Qualitative engagement methods that intentionally include a more diverse population and determining the appropriate format for specific questions may lead to results that are be more generalizable. The educational webinar was well received, and several participants opted to serve as I-REP panelists to collaborate with trauma researchers moving forward.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001466"},"PeriodicalIF":2.1,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}