Sri Lanka Journal of Trauma最新文献

Fasciotomy done for vascular trauma at a tertiary care centre in Sri Lanka 斯里兰卡一家三级医疗中心为血管创伤进行的筋膜切开术

Sri Lanka Journal of Trauma Pub Date : 2024-03-01 DOI: 10.62474/uhxt2336

J. Arudchelvam

{"title":"Fasciotomy done for vascular trauma at a tertiary care centre in Sri Lanka","authors":"J. Arudchelvam","doi":"10.62474/uhxt2336","DOIUrl":"https://doi.org/10.62474/uhxt2336","url":null,"abstract":"Introduction Compartment syndrome is a major factor contributing to limb loss and poor outcome following lower limb vascular injuries. Method This is a retrospective study done on patients with vascular injuries and undergone fasciotomy at the accident service operation theatre (ASOT) at the national hospital of Sri Lanka (NHSL), during a period of one year. Cases with Incomplete documentation were excluded. Data on patient demographics, time of injury, and time of fasciotomy, associated fractures, muscle viability and outcome were collected. Results A total of 30 cases were included. 26 (86%) were males. Nine (30%) were upper limb and 21(70%) were lower limb fasciotomy. The cause for limb injuries were road traffic accidents (RTA) in 18 (58.1%), trap gun injury in five (16.1%). All the fasciotomy were done prior to revascularization. 19 (63.3%) had fractures (12 (63%) were open and seven (36%) closed). six (20%) fasciotomy were done for compartment syndrome, 24 (80%) were done prophylactically. Three patients with compartment syndrome had open fractures (50%) and three had closed fractures (50%). On fasciotomy, in four cases all four leg compartment muscles were non-viable, two had non-viable three compartments and one patient had non-viable two compartments. The mean delay in patients who had all compartments viable was 3.7 hours (2-6.5) and the mean delay in patients with three or four non-viable compartments was 12.2hours (7-24). This difference was statistically significant (p-0.0001). The fasciotomy delay was also significant (p-0.0001) between the patients who had an amputation and limb salvage. Overall amputation rate was 20% in this series. Mean time of delay from admission to NHSL to the time of fasciotomy was 1.8 hours (1-3.5). Mean time of injury to time of fasciotomy was 5.42 hours (2-24). Discussion Number of non-viable compartments is significantly associated with the duration between time of injury to time of fasciotomy(P-0.0001). Therefore we suggest early fasciotomy before transfer","PeriodicalId":517947,"journal":{"name":"Sri Lanka Journal of Trauma","volume":"54 S7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140401782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A patient with penetrating cardiac trauma: A real time test of integrity in the trauma care system in Sri Lanka 一名穿透性心脏创伤患者：对斯里兰卡创伤护理系统完整性的实时考验

Sri Lanka Journal of Trauma Pub Date : 2024-03-01 DOI: 10.62474/ydfk5311

Mihira Bandara, D. Bandara

引用次数: 0

Severe liver injuries; a case series and review of the literature 严重肝损伤；病例系列和文献综述

Sri Lanka Journal of Trauma Pub Date : 2024-03-01 DOI: 10.62474/sljt-xyof6534

J. Arudchelvam

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Editorial -01 编辑 -01

Sri Lanka Journal of Trauma Pub Date : 2024-03-01 DOI: 10.62474/sljt-kbix1314

gayan ekanayake

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Resilience in terror and disaster medicine through consolidation of institutional memory - National Hospital Sri Lanka Easter Sunday 2019 experience 通过巩固机构记忆提高恐怖和灾难医疗的复原力 - 斯里兰卡国立医院 2019 年复活节周日经验

Sri Lanka Journal of Trauma Pub Date : 2024-03-01 DOI: 10.62474/uufv1217

K. Abayajeewa, Amila Ratnayake

引用次数: 0

Salvaging mangled upper limbs with early soft tissue cover with flaps- A case series 通过皮瓣早期软组织覆盖抢救上肢断端--病例系列

Sri Lanka Journal of Trauma Pub Date : 2024-03-01 DOI: 10.62474/gzpa7784

O. Basnayake, G. Ekanayake

{"title":"Salvaging mangled upper limbs with early soft tissue cover with flaps- A case series","authors":"O. Basnayake, G. Ekanayake","doi":"10.62474/gzpa7784","DOIUrl":"https://doi.org/10.62474/gzpa7784","url":null,"abstract":"Mutilating upper limb injuries present complex challenges to both patients and surgeons, necessitating prompt and effective management strategies to achieve favorable outcomes. This retrospective study examines the cases of five consecutive patients with mangled upper limbs resulting from blunt trauma, evaluating demographics, injury mechanisms, injury patterns, and 60-day limb salvage outcomes. Among 2128 admissions between January and December 2022, five patients were identified with mangled upper limbs and open fractures, with an average age of 40.2 years and a notable male predominance (80%). The dominant hand was affected in 60% of cases, primarily due to blunt high-velocity road traffic accidents. The mean Mangled Extremity Severity Score (MESS) was 7.2, and the Ganga Hospital Open Injury Score averaged 16, indicating substantial injury severity without limb ischemia or compartment syndrome. All patients underwent definitive surgery within 48 hours, with various soft tissue reconstruction techniques employed, including free flaps, pedicle flaps, and local muscle mobilization, along with nerve grafting procedures. At the 60-day follow-up, successful limb salvage was achieved in all cases, with no instances of surgical site infection and excellent acceptance of skin grafted areas exceeding 95%. The findings underscore the importance of timely surgical intervention and comprehensive soft tissue coverage in achieving successful limb salvage outcomes in patients with mutilating upper limb injuries, emphasizing the critical role of early intervention and multidisciplinary collaboration.","PeriodicalId":517947,"journal":{"name":"Sri Lanka Journal of Trauma","volume":"26 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140286529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Vascular injury pattern and workload; A tertiary care center experience from Sri Lanka 血管损伤模式和工作量；斯里兰卡三级医疗中心的经验

Sri Lanka Journal of Trauma Pub Date : 2024-03-01 DOI: 10.62474/sljt-czfw6850

Dulanjana Ranasinghe

引用次数: 0

Forging alliances: examining civil-military partnerships and their impact on war-time casualty care in Sri Lanka 结成联盟：研究斯里兰卡的军民伙伴关系及其对战时伤员护理的影响

Sri Lanka Journal of Trauma Pub Date : 2024-03-01 DOI: 10.62474/dgjr2507

A. Ratnayake, Sanjeewa Munasinghe, Gamini Goonetilleke

{"title":"Forging alliances: examining civil-military partnerships and their impact on war-time casualty care in Sri Lanka","authors":"A. Ratnayake, Sanjeewa Munasinghe, Gamini Goonetilleke","doi":"10.62474/dgjr2507","DOIUrl":"https://doi.org/10.62474/dgjr2507","url":null,"abstract":"Over the course of the 26-year civil war in Sri Lanka between the Liberation Tigers of Tamil Eelam (LTTE) and the government forces, LTTE’s ‘military’ capacity and strategy evolved from guerrilla-type ambushes using landmines to semi-conventional warfare with light arms and eventually to heavy artillery and improvised explosive devices. This evolution required both military and civil surgeons to enhance their knowledge and skills in managing high-energy war wounds to handle the large number of casualties admitted to health institutions. The Sri Lanka Medical Corps (SLMC) had been meticulously organized into echelons of care with graded capacity and capability to medivac battle injured personnel from point of injury to definitive care facilities. All injured personnel eventually found their way to Colombo Army Hospital and Ragama Rehabilitation Hospital for comprehensive rehabilitation. The civil war in Sri Lanka presented a significant influx of war-related injuries, demanding the creation of a comprehensive system seamlessly integrating both military and civilian elements. With a decade of peace, accompanied by shifts in injury epidemiology, the evolving landscape has mandated the exploration of innovative strategies to sustain and enhance the surgical skill-base for both military and civilian casualty care.","PeriodicalId":517947,"journal":{"name":"Sri Lanka Journal of Trauma","volume":"350 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140402227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Life-threatening airway injury following blunt thoracic trauma. 胸部钝挫伤后危及生命的气道损伤。

Sri Lanka Journal of Trauma Pub Date : 2024-03-01 DOI: 10.62474/sljt-txak2497

Saman Pradeep

引用次数: 0

Traumatic elbow dislocations 外伤性肘关节脱位

Sri Lanka Journal of Trauma Pub Date : 2024-03-01 DOI: 10.62474/fgdb3996

M. Amarasooriya

{"title":"Traumatic elbow dislocations","authors":"M. Amarasooriya","doi":"10.62474/fgdb3996","DOIUrl":"https://doi.org/10.62474/fgdb3996","url":null,"abstract":"Elbow dislocations occur mostly in the young adult population and nearly 50% occur during sporting activities. Diagnosis and assessment of concentric reduction following manipulation are performed using plain radiography and fluoroscopy. Computed Tomography (CT) enable identifying subtle fractures that can otherwise lead to chronic instability. Simple dislocations by definition have no associated fractures and complex dislocations are associated with a variety of fractures, with the terrible triad injury and trans-humeral dislocations leading to surgical challenges. Assessment of the direction and the mechanics of elbow dislocation enable identify the structures that have been injured. Posterior and posterolateral dislocations are the most common patterns, where the lateral ligament complex is often compromised. Most simple dislocations are amenable to reduction, immobilization, and gradual rehabilitation resulting in good functional outcome. Ongoing instability can occur in 10% of the patients. Complex dislocations pose a surgical challenge and lead to joint stiffness, pain and ongoing instability if not managed properly. Identifying the individual component of a complex dislocation such as radial head fractures, coronoid fractures, proximal ulnar fractures, and ligament injures is important for satisfactory outcome.","PeriodicalId":517947,"journal":{"name":"Sri Lanka Journal of Trauma","volume":"1164 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140286428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0