The journal of cardiothoracic trauma最新文献_第8页

Trends in hospitalization associated with traumatic brain injury in a publicly insured population, 1992-2002. 1992-2002年公共保险人口中与创伤性脑损伤相关的住院趋势。

The journal of cardiothoracic trauma Pub Date : 2009-01-01 DOI: 10.1097/TA.0b013e3181715d66

A. Colantonio, R. Croxford, S. Farooq, A. Laporte, P. Coyte

{"title":"Trends in hospitalization associated with traumatic brain injury in a publicly insured population, 1992-2002.","authors":"A. Colantonio, R. Croxford, S. Farooq, A. Laporte, P. Coyte","doi":"10.1097/TA.0b013e3181715d66","DOIUrl":"https://doi.org/10.1097/TA.0b013e3181715d66","url":null,"abstract":"BACKGROUND Traumatic brain injury (TBI) is a leading cause of death and disability in developed countries. We document trends in TBI-related hospitalizations in Ontario, Canada, between April 1992 and March 2002, focusing on relationships between inpatient hospitalization rates, age, sex, cause of injury, severity level, and in-hospital mortality. METHODS Information on all acute hospital separations in Ontario with a diagnosis of TBI was analyzed using logistic regression. RESULTS Hospitalization rates fell steeply among children and young adults but remained stable among adults aged 66 and older. The proportion of TBI hospitalizations with mild injuries decreased from 75% to 54%, whereas the proportion with moderate injuries increased from 19% to 37%. Adjusting for other risk factors, in-hospital deaths were higher for injuries because of motor vehicle crashes than those because of falls. In-hospital death rates were stable for patients with moderate or severe injuries, but increased over time among those whose injuries were classified as mild, suggesting a trend toward more serious injury within the \"mild\" classification. CONCLUSIONS Hospitalizations for TBI involve fewer mild injuries over time and are highest in the oldest segment of the population.","PeriodicalId":92962,"journal":{"name":"The journal of cardiothoracic trauma","volume":"08 1","pages":"179-83"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86046597","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: 87

Inequity of rehabilitation services after traumatic injury. 创伤后康复服务不公平。

The journal of cardiothoracic trauma Pub Date : 2009-01-01 DOI: 10.1097/TA.0b013e31815ede46

R. Nirula, Gina Nirula, L. Gentilello

{"title":"Inequity of rehabilitation services after traumatic injury.","authors":"R. Nirula, Gina Nirula, L. Gentilello","doi":"10.1097/TA.0b013e31815ede46","DOIUrl":"https://doi.org/10.1097/TA.0b013e31815ede46","url":null,"abstract":"BACKGROUND The delivery of optimal trauma care involves identification and repair of injuries as well as rehabilitation of patients to return them to their preinjury functional status. This requires access to appropriate rehabilitation services; however, such services may be disproportionately allocated to insured individuals leaving lower income individuals without the means to achieve optimal functional status. We hypothesized that a lack of insurance is associated with a reduced likelihood of being transferred to a rehabilitation facility after trauma. METHODS A retrospective cohort analysis of blunt National Trauma Databank patients from 2000 to 2004 were assessed to identify predictors of being transferred to a rehabilitation facility at hospital discharge. The likelihood of rehabilitation transfer based on insurance status was assessed, controlling for injury severity, physiology, comorbidities, and patient demographics. RESULTS Age, gender, comorbidities, injury, presence of blood alcohol at admission, race, and insurance status were independent predictors of being transferred to a rehabilitation facility among blunt trauma patients (n = 750,468). Patients who were uninsured were 53% (OR = 0.47, 95% CI = 0.41-0.53) less likely to be transferred to a rehabilitation facility upon hospital discharge. CONCLUSION Although access to rehabilitation services after injury is a key predictor of recovery from injury, these services are much less available to uninsured patients. This may lead to significant individual and societal emotional and economic burden. The health and economic impacts of this disparity in access to care need to be investigated to determine the personal and societal impact of appropriate resource allocation to rehabilitation for the uninsured.","PeriodicalId":92962,"journal":{"name":"The journal of cardiothoracic trauma","volume":"79 1","pages":"255-9"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72867250","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: 82

Effect of 35 degrees C hypothermia on intracranial pressure and clinical outcome in patients with severe traumatic brain injury. 35℃低温对重型颅脑损伤患者颅内压及临床预后的影响。

The journal of cardiothoracic trauma Pub Date : 2009-01-01 DOI: 10.1097/TA.0b013e318157dbec

T. Tokutomi, T. Miyagi, Y. Takeuchi, Takashi Karukaya, H. Katsuki, M. Shigemori

{"title":"Effect of 35 degrees C hypothermia on intracranial pressure and clinical outcome in patients with severe traumatic brain injury.","authors":"T. Tokutomi, T. Miyagi, Y. Takeuchi, Takashi Karukaya, H. Katsuki, M. Shigemori","doi":"10.1097/TA.0b013e318157dbec","DOIUrl":"https://doi.org/10.1097/TA.0b013e318157dbec","url":null,"abstract":"BACKGROUND From 1994, we have used therapeutic hypothermia in patients with severe traumatic brain injury (Glasgow Coma Scale scores of 5 or less). In 2000, we altered the target temperature to 35 degrees C from the former 33 degrees C, as our findings suggested that cooling to 35 degrees C is sufficient to control intracranial hypertension, and that hypothermia below 35 degrees C may predispose patients to persistent cumulative oxygen debt. We attempted to clarify whether 35 degrees C hypothermia has the same effect as 33 degrees C hypothermia in reducing intracranial hypertension and whether it is associated with fewer complications and improved outcomes. METHODS We compared intracranial pressure (ICP) and biochemical parameters in the 30 patients treated with 35 degrees C hypothermia (January 2000 to June 2005) with those in the 31 patients treated with 33 degrees C hypothermia (July 1994 to December 1999). RESULTS Patient characteristics were similar in the two groups. The mean temperature during hypothermia was 35.1 +/- 0.7 degrees C in the 35 degrees C hypothermia group and 33.4 +/- 0.8 degrees C in the 33 degrees C hypothermia group. Mean ICP was controlled under 20 mm Hg during hypothermia in both the 35 degrees C hypothermia and 33 degrees C hypothermia groups. The incidence of intracranial hypertension and low cerebral perfusion pressure did not differ between the two groups. The 35 degrees C hypothermic patients exhibited a significant improvement in the decline of serum potassium concentrations during hypothermia and in the increment of C-reactive protein after rewarming. The mortality rate and the incidence of systemic complications tended to be lower in the 35 degrees C group. CONCLUSIONS Cooling patients to 35 degrees C is safe and the ICP reduction effects of 35 degrees C hypothermia are similar to those of 33 degrees C hypothermia.","PeriodicalId":92962,"journal":{"name":"The journal of cardiothoracic trauma","volume":"69 1","pages":"166-73"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83825406","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: 63

34th William Fitts Jr oration: the parathyroid response to acute hemorrhage, sepsis, and multiple organ failure. 第34届威廉·菲茨演讲:甲状旁腺对急性出血、败血症和多器官衰竭的反应。

The journal of cardiothoracic trauma Pub Date : 2009-01-01 DOI: 10.1097/TA.0b013e3181929ce3

C. Lucas

引用次数: 3

Outcome of cervical near-hanging injuries. 颈部近悬挂损伤的结果。

The journal of cardiothoracic trauma Pub Date : 2009-01-01 DOI: 10.1097/TA.0b013e31817f2c57

S. Nichols, M. McCarthy, A. P. Ekeh, R. Woods, M. Walusimbi, J. Saxe

{"title":"Outcome of cervical near-hanging injuries.","authors":"S. Nichols, M. McCarthy, A. P. Ekeh, R. Woods, M. Walusimbi, J. Saxe","doi":"10.1097/TA.0b013e31817f2c57","DOIUrl":"https://doi.org/10.1097/TA.0b013e31817f2c57","url":null,"abstract":"BACKGROUND Cervical near-hangings are not rare, but have received little attention in the trauma literature. Increasing numbers of patients received from our local jail and detention centers prompted this study. METHODS Seventeen-year review of a level I Trauma Center Registry identified 67 patients with cervical strangulation for study. Data were analyzed using the Mann-Whitney test to evaluate continuous predictors, and Fisher's exact test for categorical predictors. RESULTS Ten of 67 patients died (14.9% mortality). Patients having a lower Glasgow Coma Score (GCS) at the scene (3.5 +/- 1.3 vs. 8.3 +/- 5.0; p = 0.001) and lower GCS in the emergency department (ED) (3.0 +/- 0.0 vs. 9.0 +/- 5.3; p < 0.001) were more likely to die. Injuries consisted predominantly of neck abrasions and anoxic brain injuries (83% mortality). Laryngeal fractures and carotid arterial injuries were detected. No cervical spine fractures were seen, but subluxations were identified. Forty-two percent of the patients were in detention centers when the near-hanging incident occurred. CONCLUSIONS Cervical near-hangings are referred to the Trauma Service for evaluation. Scene or ED GCS of 3 does not preclude neurologically intact survival, although mortality is high. In our study, the most useful prognostic factors were the need for airway control by intubation or cricothyrotomy, cardiopulmonary resuscitation, lower scene and ED GCS, and cerebral edema on CT Scan. Optimal evaluation includes head and neck CT and CT angiography of the neck. We plan to share these results with local authorities and encourage improvement in risk identification, with earlier involvement of mental health personnel.","PeriodicalId":92962,"journal":{"name":"The journal of cardiothoracic trauma","volume":"71 1","pages":"174-8"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90807729","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: 36

TLR4 is essential in acute lung injury induced by unresuscitated hemorrhagic shock. TLR4在未复苏失血性休克引起的急性肺损伤中起重要作用。

The journal of cardiothoracic trauma Pub Date : 2009-01-01 DOI: 10.1097/TA.0b013e318181e555

T. Lv, Xiao-kun Shen, Yi Shi, Yong Song

{"title":"TLR4 is essential in acute lung injury induced by unresuscitated hemorrhagic shock.","authors":"T. Lv, Xiao-kun Shen, Yi Shi, Yong Song","doi":"10.1097/TA.0b013e318181e555","DOIUrl":"https://doi.org/10.1097/TA.0b013e318181e555","url":null,"abstract":"BACKGROUND Acute lung injury (ALI) and acute respiratory distress syndrome in patients with hemorrhagic shock (HS) or resuscitation is associated with the expression of TLR4. However, the role of TLR4 in ALI induced by unresuscitated HS remains obscure. METHODS The lung pathologic change was observed by hematoxylin and eosin staining. Interleukin-1beta and tumor necrosis factor-alpha were analyzed by enzyme-linked immunosorbent assay. Polymorphonuclear leukocyte sequestration and lung leak were analyzed by pulmonary myeloperoxidase activity and Evans blue dye. The expressions of TLR4 mRNA and protein were analyzed by reverse transcription-polymerase chain reaction and Western blot, respectively. TLR4 distribution was analyzed by immunohistochemistry. RESULTS Lung neutrophil accumulation and microvascular permeability were significantly increased after unresuscitated HS, meanwhile, lung interleukin-1beta and tumor necrosis factor-alpha were gradually augmented. TLR4 mRNA, TLR4 distribution and TLR4 protein were also significantly increased in TLR4 wt mice, however, no above-mentioned changes appeared in TLR4 mutant mice. CONCLUSIONS TLR4 is strongly associated with the pathogenesis of ALI induced by unresuscitated HS, which may serve as a useful therapeutic target.","PeriodicalId":92962,"journal":{"name":"The journal of cardiothoracic trauma","volume":"57 1","pages":"124-31"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89422657","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: 35

Pentoxifylline modulates intestinal tight junction signaling after burn injury: effects on myosin light chain kinase. 己酮茶碱调节烧伤后肠紧密连接信号:对肌球蛋白轻链激酶的影响。

The journal of cardiothoracic trauma Pub Date : 2009-01-01 DOI: 10.1097/TA.0b013e318191bb1f

Todd W. Costantini, W. Loomis, James G. Putnam, Lauren Kroll, B. Eliceiri, A. Baird, V. Bansal, R. Coimbra

{"title":"Pentoxifylline modulates intestinal tight junction signaling after burn injury: effects on myosin light chain kinase.","authors":"Todd W. Costantini, W. Loomis, James G. Putnam, Lauren Kroll, B. Eliceiri, A. Baird, V. Bansal, R. Coimbra","doi":"10.1097/TA.0b013e318191bb1f","DOIUrl":"https://doi.org/10.1097/TA.0b013e318191bb1f","url":null,"abstract":"BACKGROUND Burn injury can result in loss of intestinal barrier function, leading to systemic inflammatory response syndrome and multiorgan failure. Myosin light chain kinase (MLCK), a tight junction protein involved in the regulation of barrier function, increases intestinal epithelial permeability when activated. Prior studies have shown that tumor necrosis factor (TNF)-alpha activates MLCK, in part through a nuclear factor (NF)-kappa B-dependent pathway. We have previously shown that pentoxifylline (PTX) decreases both TNF-alpha synthesis and NF-kappaB activation in models of shock. Therefore, we postulate that PTX will attenuate activation of the tight junction protein MLCK, which may decrease intestinal tight junction permeability after severe burn. METHODS Male balb/c mice undergoing a severe burn were randomized to resuscitation with normal saline (NS) or NS + PTX (12.5 mg/kg). Intestinal TNF-alpha levels were evaluated using enzyme linked immunosorbent assay. Gut extracts were obtained to assess MLCK, phosphorylated IKK, IkappaB-alpha, and NF-kappaB p65 levels by immunoblotting. RESULTS Burn injury increased intestinal MLCK protein levels threefold in animals resuscitated with NS, whereas those receiving PTX had MLCK levels similar to control (p < 0.01). Treatment with PTX attenuated burn-induced intestinal permeability. PTX decreased cytoplasmic IKK, IkappaB-alpha phosphorylation, and nuclear NF-kappaB p65 translocation to sham levels (p < 0.05 vs. NS). CONCLUSION Treatment with PTX attenuates activation of the tight junction protein MLCK, likely through its ability to decrease local TNF-alpha synthesis and NF-kappaB activation after burn. PTX may have therapeutic utility by decreasing intestinal barrier breakdown after burn.","PeriodicalId":92962,"journal":{"name":"The journal of cardiothoracic trauma","volume":"43 8 1","pages":"17-24; discussion 24-5"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85824354","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: 46

Scoring mandibular fractures: a tool for staging diagnosis, planning treatment, and predicting prognosis. 下颌骨折评分:分期诊断、计划治疗和预测预后的工具。

The journal of cardiothoracic trauma Pub Date : 2009-01-01 DOI: 10.1097/TA.0b013e318194560b

F. Carinci, L. Arduin, F. Pagliaro, I. Zollino, G. Brunelli, R. Cenzi

{"title":"Scoring mandibular fractures: a tool for staging diagnosis, planning treatment, and predicting prognosis.","authors":"F. Carinci, L. Arduin, F. Pagliaro, I. Zollino, G. Brunelli, R. Cenzi","doi":"10.1097/TA.0b013e318194560b","DOIUrl":"https://doi.org/10.1097/TA.0b013e318194560b","url":null,"abstract":"BACKGROUND Mandibular fractures (MF) are a daily problem in maxillofacial surgery. A staging system for classifying MF is of paramount importance to plan surgery, to define prognosis, and to exchange information among trauma centers. In this article, a classification for MF is proposed. METHODS The mandible is divided into six sites (symphysis, body, angle, ramus, coronoid, and condyle) and the mandibular nerve divides the alveolar process (i.e., the upper part containing teeth) from the basal bone (placed caudally with respect to the nerve). MF can be summarized using three abbreviations: A = alveolar, B = basal, and C = complete. Consequently, MFs are staged as follows: F in situ = a greenstick fracture; F1 = a single mobile fragment of alveolar or basal bone; F2 = double mobile fractures of the alveolar or basal portion or a single complete separation of the mandibular arch continuity; F3 = a complete double separation of the mandibular arch continuity; F4 = triple or more mandibular arch fragments. To evaluate the suitability of the proposed classification, a retrospective study on a series of 128 patients (and 205 MFs) was performed. Age, gender, stage, clinical diagnosis at admission, type of surgery, and outcome were considered. RESULTS A good correlation between the proposed classification and the studied variables was detected. CONCLUSIONS The new classification is a simple and precise method for staging MF. It can summarize MFs and be used in daily practice. It is our understanding, however, that a multicenter study should be performed before the effectiveness of the proposed classification can be clearly stated.","PeriodicalId":92962,"journal":{"name":"The journal of cardiothoracic trauma","volume":"317 1","pages":"215-9"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80136906","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: 19

Does acuity matter?--Optimal timing of tracheostomy stratified by injury severity. 敏锐度重要吗?-根据损伤严重程度分层气管切开术的最佳时机。

The journal of cardiothoracic trauma Pub Date : 2009-01-01 DOI: 10.1097/TA.0b013e31816073e3

Jason M Schauer, L. Engle, David T Maugher, R. Cherry

{"title":"Does acuity matter?--Optimal timing of tracheostomy stratified by injury severity.","authors":"Jason M Schauer, L. Engle, David T Maugher, R. Cherry","doi":"10.1097/TA.0b013e31816073e3","DOIUrl":"https://doi.org/10.1097/TA.0b013e31816073e3","url":null,"abstract":"BACKGROUND A number of conflicting studies have been conducted to analyze the relationship between the timing of tracheostomy and mortality, intensive care unit (ICU) length of stay (LOS), hospital LOS, and the incidence of pneumonia. In contrast to previous studies, this relationship was investigated in the context of expected survival based on probability of survival (Ps) greater than 25%. METHODS Trauma patients were screened using a statewide registry during a 5-year period (January 2001 to December 2005). Burn patients, transfer patients, permanent tracheostomies, and patients who underwent multiple surgical airways were excluded from the study. Data were collected on patient demographics, Trauma and Injury Severity Score, days to tracheostomy, mortality, ICU LOS, total ventilator days, pneumonia, and hospital LOS. STATISTICAL ANALYSES log-linear modeling, chi2, p < 0.05. RESULTS A total of 125,533 trauma patients were analyzed. Out of these, 82,148 patients met inclusion criteria and had complete data for analysis. There were 6,880 patients intubated at the scene, during transport, or at admission to the emergency department, with 685 receiving a temporary tracheostomy. There was a significantly higher mortality rate (48.9%) associated with patients with low Ps (<0.25) receiving early tracheostomy (ET), <4 days. Among high-Ps patients, the ET group demonstrated reduced ICU LOS, total ventilator days, pneumonia, and hospital LOS (p < 0.05). CONCLUSION ET in patients with low Ps may not be beneficial given the substantially high mortality rate before post injury day 4. However, ET in high-Ps patients reduces ICU and hospital LOS, total ventilator days, and the incidence of pneumonia. This suggests an increased benefit in ET to trauma patients with high Ps.","PeriodicalId":92962,"journal":{"name":"The journal of cardiothoracic trauma","volume":"22 1","pages":"220-5"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81431958","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: 32

Bioprosthetic repair of complex duodenal injury in a porcine model. 猪复杂十二指肠损伤模型的生物修复。

The journal of cardiothoracic trauma Pub Date : 2009-01-01 DOI: 10.1097/TA.0b013e318191bdd6

M. Eckert, J. Perry, Vance Y. Sohn, Joren B. Keylock, J. Munaretto, A. Beekley, Matthew J. Martin

{"title":"Bioprosthetic repair of complex duodenal injury in a porcine model.","authors":"M. Eckert, J. Perry, Vance Y. Sohn, Joren B. Keylock, J. Munaretto, A. Beekley, Matthew J. Martin","doi":"10.1097/TA.0b013e318191bdd6","DOIUrl":"https://doi.org/10.1097/TA.0b013e318191bdd6","url":null,"abstract":"BACKGROUND Complex duodenal injury remains a challenging problem for the trauma surgeon. Although primary repair of small injuries is often possible, extensive damage requires complex enteric reconstruction and drainage procedures. We sought to determine the efficacy of a bioprosthetic repair for large duodenal wounds in a porcine model. METHODS A 60% circumferential wall defect in the second portion of the duodenum was created in eight female Yorkshire swine (38 kg +/- 5 kg). After 30 minutes of peritoneal soilage, a bioprosthetic repair using 1.5 mm porcine acellular dermal matrix was performed. Animals were recovered and resumed a normal diet on day 3. Repeat abdominal exploration and anastomotic bursting pressure strength was performed at 1-, 2-, 3-, and 6-week intervals. Pathologic analysis of all specimens was performed. RESULTS All animals tolerated a normal diet postoperatively, with progressive weight gain and normal bowel function. On re-exploration, no animal had evidence of duodenal stenosis, proximal dilation, or abscess formation. Pathologic analysis demonstrated progressive in-growth of native bowel tissue, with almost complete incorporation at 6 weeks. Mean bursting pressure (202 mm Hg +/- 60 mm Hg) occurred at native bowel, not patch repair site, in three of eight animals. CONCLUSION Bioprosthetic repair of enteric wall defects, even in proximity to upper intestinal secretions, allows successful recovery of bowel function and injury repair without extensive anatomic reconstruction. This technique may provide a more conservative approach to the treatment of complex duodenal injuries after trauma.","PeriodicalId":92962,"journal":{"name":"The journal of cardiothoracic trauma","volume":"1 1","pages":"103-9"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88721167","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: 4