Burns & TraumaPub Date : 2023-09-04DOI: 10.22141/1608-1706.2.24.2023.941
O. Tyazhelov, O. Karpinska, M. Karpinsky, O.A. Nikolchenko, V. Fishchenko, Khasawneh Ayham Adli Mohammad
{"title":"The influence of low-frequency vibration on the restoration of the range of knee motion in laboratory animals after immobilization (experimental study)","authors":"O. Tyazhelov, O. Karpinska, M. Karpinsky, O.A. Nikolchenko, V. Fishchenko, Khasawneh Ayham Adli Mohammad","doi":"10.22141/1608-1706.2.24.2023.941","DOIUrl":"https://doi.org/10.22141/1608-1706.2.24.2023.941","url":null,"abstract":"Background. The term “joint contractures” is used to describe the loss of passive range of motion of diarthrosis joints, the most common and mobile type of a joint. Measuring passive or active range of motion in a joint with contracture is key to assessing the severity of joint contractures. The purpose of the study: to determine the impact of immobilization on the development of movement limitation in the knee joint of laboratory animals (rats) and to evaluate the possibility of restoring mobility in case of using low-frequency vibration during and after immobilization. Materials and methods. The experimental study was conducted on 30 non-linear white male rats aged 6 months. Immobilization of the pelvic limb was performed at an angle of 140° in the knee joint. The animals were randomly divided into 3 groups: I — immobilization and free restraint after immobilization, II — immobilization and vibration development of the joint after immobilization, III — immobilization and vibration development of the joint during and after immobilization. Vibration development of the immobilized knee joint was performed daily in the mode of 20 Hz with an amplitude of 1.5 mm and a duration of 10 minutes. The range of motion and real contracture were determined as the difference between the measured range of motion and the range of motion before the start of the experiment for each animal individually. Results. It was found that a rapid increase in movement limitation occurs starting from the 2nd week of immobilization. A decrease in the range of motion in rats of the groups I and II under conditions of immobilization occurred the same way. After the end of immobilization, a slow increase in the range of motion was observed in the group I; in the group II, the growth was almost linear and after 4 weeks, the indicator was close to the norm. In the group III, the limitation of the range of motion after immobilization was significantly less; therefore, accordingly, recovery took place already 2 weeks after the removal of the immobilization bandage. Immobilization of the knee joint in rats of groups I and II caused a contracture of 60°, while in the group III, the restrictions did not exceed 25°. And, accordingly, the recovery in the groups with vibration development was rapid; in the group III, a full recovery was achieved, in the group II — a recovery of up to 5° of the residual contracture. In the group I, we observe a residual contracture of almost 35°, which is more than the formed immobilization contracture in the group III. Conclusions. Low-frequency vibration allows reducing the impact of immobilization and significantly accelerate the recovery of mobi-lity (range of motion) of the joint after its completion. If it is impossible to carry out vibrotherapy during the period of immobilization, it should be started as early as possible after immobilization. To date, there are few studies considering the effect of low-frequency vibration on the development of immob","PeriodicalId":9553,"journal":{"name":"Burns & Trauma","volume":null,"pages":null},"PeriodicalIF":5.3,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77026819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Burns & TraumaPub Date : 2023-09-04DOI: 10.22141/1608-1706.2.24.2023.939
K. Popsuyshapka, O.V. Kovernyk, O.O. Pidgayska, M. Karpinsky, O. Yaresko
{"title":"Study of the stress-strain state of the posterior lumbar fusion models in case of normal indicators of the sagittal balance of the spine and pelvis","authors":"K. Popsuyshapka, O.V. Kovernyk, O.O. Pidgayska, M. Karpinsky, O. Yaresko","doi":"10.22141/1608-1706.2.24.2023.939","DOIUrl":"https://doi.org/10.22141/1608-1706.2.24.2023.939","url":null,"abstract":"Background. Patients suffering from hip-spine syndrome with significant changes in the hip joint complain of pain in the lumbar spine in 21.2–49.4 % of cases. After performing lumbar fusion, the mobility of the pelvis decreases, which leads to an increased risk of dislocations and the development of impingement after hip arthroplasty that is the cause for repeated surgical interventions. Goal: to study the stress distribution in the models of posterior lumbar fusion in case of normal values of the sagittal contour of the spine and lumbar lordosis. Materials and methods. A finite-element model has been developed reflecting the condition that occurs in the combined course of degenerative diseases of the lumbar spine and hip joint and is characterized by normal lordosis of 40º and forward body tilt due to flexion contracture in the hip joints. The following options were modeled: 1 — posterior fusion of the L4-L5 vertebrae using a transpedicular structure with 4 screws and an interbody support; 2 — posterior fusion of the L3-L4-L5 vertebrae using a transpedicular construction with 6 screws; 3 — posterior fusion of L1-L5 vertebrae using a transpedicular structure with 10 screws. When conducting the research, the values of stresses in the Th1-L5 vertebrae, on the screws and rods of the transpedicular structure were studied. Results. Posterior fusion with a transpedicular construction on two L4-L5 vertebrae leads to the occurrence of maximum stresses in vertebral bodies of the lumbar spine, especially L4-L5. The lowest stresses in the lumbar vertebral bodies can be obtained when the transpedicular structure is applied to all 5 vertebrae. The use of all options for posterior fusion, except for the 4-screw scheme, allows to reduce the stress in the vertebral arches of the lumbar spine below the level of the normal spine model, except for the L1 vertebra. This leads to an increase in the level of stress from the Th6 to Th12 vertebrae. The construction placed on all 5 vertebrae ensures the lowest level of stress in the arches of thoracic vertebrae. The construction placed on all the vertebrae of the lumbar spine provides a minimum level of stress in the bone tissue around the fixing screws. Reducing the length of fixation leads to a significant increase in stress in these zones. With all types of installation of the transpedicular construction, the values of the stresses on the screws in the L3-L5 vertebrae are comparable. When using the design for 5 vertebrae of the lumbar spine, the locking screws in the L1 and L2 vertebrae will experience significant loads, which, accordingly, will cause significant stress in them. The maximum level of stress in the rods occurs when two L4-L5 vertebrae are instrumented, the minimum is when the structure is placed on all five vertebrae of the lumbar spine. Conclusions. Given the stress distribution, the length of fixation plays an important role: the longer the length of fixation, the lower the stress level, both in the b","PeriodicalId":9553,"journal":{"name":"Burns & Trauma","volume":null,"pages":null},"PeriodicalIF":5.3,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81282202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Burns & TraumaPub Date : 2023-09-04DOI: 10.22141/1608-1706.2.24.2023.946
V.V. Shtroblya, S.S. Philip, S.M. Drogovoz
{"title":"Pharmacological correction of the pathogenesis and symptoms of osteoarthritis of the knee","authors":"V.V. Shtroblya, S.S. Philip, S.M. Drogovoz","doi":"10.22141/1608-1706.2.24.2023.946","DOIUrl":"https://doi.org/10.22141/1608-1706.2.24.2023.946","url":null,"abstract":"Background. Osteoarthritis of the knee (OAK) causes severe pain and sometimes disability, which reduces the quality of life and work capacity of patients. Today, the prevalence of OAK is increases; therefore, the development of methods for its treatment and the use of means that slow down or stop the progression of OAK are relevant. Since OAK is a slowly progressive disease, the search for effective drugs with minimal toxicity and a long-lasting effect, which prevent the destruction of articular cartilage and improve the working conditions of the patient, is ongoing. Thus, the main goals of OAK treatment are to reduce symptoms and slow the progression of the disease, which can reduce the negative impact of OAK on the patient’s functional capacity, as well as improve quality of life. OAK is characterized by the progressive destruction of the articular cartilage, especially when it bears a load. In the joint, cartilage aggrecan is the main structural component that provides hydrophilicity and allows to withstand compression loads. Aggrecan is a complex of proteoglycans with hyaluronic acid and is characterized by a high content of chondroitin sulfate chains, while proteoglycan consists of protein and glycosaminoglycan chains (the precursor of the latter is glucosamine). ","PeriodicalId":9553,"journal":{"name":"Burns & Trauma","volume":null,"pages":null},"PeriodicalIF":5.3,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76736196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Burns & TraumaPub Date : 2023-09-04DOI: 10.22141/1608-1706.2.24.2023.942
Wahbeh Rami Taleb Khaled, S.Y. Yaremin
{"title":"Study of bone density according to СT data before and in the remote period after unicondylar knee arthroplasty","authors":"Wahbeh Rami Taleb Khaled, S.Y. Yaremin","doi":"10.22141/1608-1706.2.24.2023.942","DOIUrl":"https://doi.org/10.22141/1608-1706.2.24.2023.942","url":null,"abstract":"Background. Unicondylar knee arthroplasty has become popular among orthopedists in recent years. The main complication of this technology is the instability of the tibial component of the endoprosthesis due to the development of local osteoporosis in the area of arthroplasty. Patients with decreased bone density are at high risk of developing instability of the tibial component of the endoprosthesis. Therefore, determining the levels of bone mineral density in patients with osteopenia before arthroplasty make it possible to calculate the risk of complications in the long term. Objective: to evaluate the bone mineral density according to the computed tomography (CT) of the tibial plateau resection zone for unicondylar arthroplasty in patients at risk. Materials and methods. The state of three cortical layer zones was assessed: anterior, middle, posterior and 4 zones of the plateau cut plane. The optical density of bone tissue was measured on CT images of the tibial plateau of the knee joint using the Hounsfield scale. Changes in bone structures in the area of placing tibial component of the endoprosthesis were studied in 2 groups of patients: group I — ten individuals who had undergone unicondylar knee arthroplasty 3–6 years ago and complained of negative phenomena in the prosthetic knee, group II — ten patients who had undergone unicondylar arthroplasty 1.2–2 years ago. These patients underwent CT densitometry at the follow-up examination. Results. Before arthroplasty, the maximum optical density of bone tissue was statistically the same. The density of the cortical layer was maximal in the anterior part of the bone (~ 720 HU), minimal — in the posterior part (580 HU). For the spongy bone zone, the maximum optical density was observed in the anterior part (~ 470 HU), and in the posterior part, it was lower. In 3–6 years, patients of group I showed a significant decrease in the optical density of the bone, both in its cortical layer and in the cancellous tissue. The greatest losses were detected in the medial zones of the cancellous bone. Patients had areas of cortical layer resorption, and in some individuals, its complete absence. At the same time, the absorption index of the cortical layer in the areas of destruction did not exceed 100 HU. The maximum optical density of the cortical layer in the zones also decreased. In patients of group II, 1.5–2 years after arthroplasty, there were no noticeable changes in the bone structures in the surgery area. Changes occurred in the medial zones of the cancellous bone of the tibial plateau. Patients with osteopenia reported changes in bone optical density already in the first years after arthroplasty, although they do not lead to instability of the tibial component of the endoprosthesis. Conclusions. Patients with decreased bone density (osteopenia) during joint arthroplasty are at risk of developing local osteoporosis in the area of bone resection. The first signs of resorption of the cancellous bone can","PeriodicalId":9553,"journal":{"name":"Burns & Trauma","volume":null,"pages":null},"PeriodicalIF":5.3,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76381208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Burns & TraumaPub Date : 2023-08-23DOI: 10.1177/14604086231187158
Carlos Satizabal Azuelo, M. P. Cabrera Méndez, Gustavo Adolfo Rozo López, Saith del Carmen Trouchon Jimenez, Diego Sanchez Cruz
{"title":"The use of transarticular external fixation by arthrodiastasis in complex open proximal humeral fractures at Hospital Militar Central Colombia: A case series","authors":"Carlos Satizabal Azuelo, M. P. Cabrera Méndez, Gustavo Adolfo Rozo López, Saith del Carmen Trouchon Jimenez, Diego Sanchez Cruz","doi":"10.1177/14604086231187158","DOIUrl":"https://doi.org/10.1177/14604086231187158","url":null,"abstract":"To describe the clinical and surgical characteristics of external fixation technique to manage complex open proximal humerus fractures caused by high-energy firearm injuries at the Hospital Militar Central, Colombia. A retrospective case series of patients with open complex proximal humerus fractures (Gustilo & Anderson III A-B or Neer III and IV) caused by long range or fragmentation weapons treated with external fixation. The variables are demographic data, range of motion, consolidation measurements, and functional outcomes according to the Quick Disabilities of the Arm, Shoulder and Hand (Quick DASH) functional scale. Seven male patients, with high-energy injuries causing open complex proximal humerus fractures (Gustilo & Anderson III A-B or Neer III or IV) underwent surgical treatment with external fixation and arthrodiastasis. Median age was 21.0 (19–24) years, mean treatment duration was 5.6 (4–7) months, and all patients completed 15 months of follow-up. Mean postoperative active movement measurements were flexion: 80° (40°–120°), abduction 85.7° (40°–130°), external rotation: 24.7° (10°–45°), and internal rotation: 23.6° (10°–45°). Mean postoperative pain according to visual analog scale was 2.7 (1–4) and mean Quick DASH was 36.2 (15.9–58). Two patients presented postoperative complications, one case each of infection and osteitis. Complex open proximal humeral fractures caused by high-energy trauma treated with transarticular external fixation via arthrodiastasis show promising short-term and mid-term results with low complication rates, low levels of postoperative pain, and moderate functional results. This external fixation technique seems to be a valid option for the treatment of polytraumatic patients with humeral injuries. Longer follow ups and larger sample sizes studies must be presented to better characterize the clinical and satisfaction outcomes.","PeriodicalId":9553,"journal":{"name":"Burns & Trauma","volume":null,"pages":null},"PeriodicalIF":5.3,"publicationDate":"2023-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83272720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Burns & TraumaPub Date : 2023-08-23DOI: 10.1177/14604086231190802
Winny Li, A. Beckett, N. Ditkofsky, G. Lebovic, Michael Pierce, A. Petrosoniak
{"title":"Who is at risk of clinical deterioration? Adverse events among trauma patients undergoing intra-hospital transport for emergent computerized tomography","authors":"Winny Li, A. Beckett, N. Ditkofsky, G. Lebovic, Michael Pierce, A. Petrosoniak","doi":"10.1177/14604086231190802","DOIUrl":"https://doi.org/10.1177/14604086231190802","url":null,"abstract":"Computerized tomography is an essential element of the early diagnostic stages of trauma care for hemodynamically stable patients. However, there are inherent challenges and risks associated with the intra-hospital transport of critically injured trauma patients to the radiology suite and during the scanning process itself. We examined the frequency and nature of adverse events during computerized tomography among critically injured patients. This is a retrospective cohort study of adverse event in critically injured adult (>18 years old) trauma patients who underwent emergent computerized tomographic scan following evaluation in the trauma bay over a 22-month period who were either admitted to the intensive care unit or the operating room post computerized tomography. Data was abstracted from the hospital's trauma registry and chart review of electronic medical records. The frequency of adverse events during computerized tomography and the associated patient transport phases was recorded. Multivariable logistic regression was performed to assess the impact of adverse event on 7-day in-hospital mortality. Of the 526 critically injured trauma patients who underwent computerized tomographic scan during the study period, 17.3% (91/526) experienced one or more adverse event. The most common adverse events were hypotension n = 50 (9.5%), hypertension n = 18 (3.4%), initiation of vasopressors n = 11 (2.1%) and vomiting n = 8 (1.5%). One patient required re-intubation following endotracheal tube dislodgement and one patient required intubation following hypoxia post-sedation for agitation. Patient factors independently associated with adverse event were mechanical ventilation and blood product administration. When adjusted for injury severity score and age, patients who experienced adverse event were at increased odds of death (odds ratio: 2.2, 95% confidence interval: 1.11–4.36) compared to those who did not experience adverse event. Adverse events occur frequently in critically injured patients undergoing emergent trauma computerized tomography and may significantly impact clinical outcomes. This study provides important information to guide system and process-level improvements including optimized designs of the built environment and safety-informed protocols for high-risk patients undergoing emergent trauma computerized tomography.","PeriodicalId":9553,"journal":{"name":"Burns & Trauma","volume":null,"pages":null},"PeriodicalIF":5.3,"publicationDate":"2023-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77337331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Burns & TraumaPub Date : 2023-07-25DOI: 10.1177/14604086231163665
Briony Seden, L. Cottey
{"title":"BestBET: Do abdominal examination findings in adult trauma patients correlate to intra-abdominal injury on CT?","authors":"Briony Seden, L. Cottey","doi":"10.1177/14604086231163665","DOIUrl":"https://doi.org/10.1177/14604086231163665","url":null,"abstract":"","PeriodicalId":9553,"journal":{"name":"Burns & Trauma","volume":null,"pages":null},"PeriodicalIF":5.3,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82688175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Burns & TraumaPub Date : 2023-07-19DOI: 10.1177/14604086231187524
H. Aghababaeian, F. Yazdi
{"title":"Prehospital emergency care for severe and acute head and neck trauma: Lessons learned from the Qatar 2022 World Cup games","authors":"H. Aghababaeian, F. Yazdi","doi":"10.1177/14604086231187524","DOIUrl":"https://doi.org/10.1177/14604086231187524","url":null,"abstract":"","PeriodicalId":9553,"journal":{"name":"Burns & Trauma","volume":null,"pages":null},"PeriodicalIF":5.3,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74211840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Burns & TraumaPub Date : 2023-07-18DOI: 10.1177/14604086231177124
Vimal Stanislaus, B. Mitra, Wen Zhang, Tom E Richardson, Nico Ng, Bjoern Picker, A. Madan, J. Mathew, M. Fitzgerald, Geoffrey W. Cloud
{"title":"The incidence and characteristics of clinically relevant blunt cerebrovascular injury at an adult level 1 trauma centre: A retrospective cohort study","authors":"Vimal Stanislaus, B. Mitra, Wen Zhang, Tom E Richardson, Nico Ng, Bjoern Picker, A. Madan, J. Mathew, M. Fitzgerald, Geoffrey W. Cloud","doi":"10.1177/14604086231177124","DOIUrl":"https://doi.org/10.1177/14604086231177124","url":null,"abstract":"Blunt cerebrovascular injuries (BCVIs) are uncommon but associated with ischemic stroke and disability, particularly in younger adults. There is a paucity of literature on the incidence and risk factors for BCVI. The aim of this study was to report the incidence and clinical characteristics of patients diagnosed with BCVI at an adult level 1 trauma centre. This was a registry-based cohort study. The accessible sample was all patients in the Alfred Hospital Trauma Registry (AHTR) who presented from January 2014 to June 2021 and were recorded to have BCVI. The diagnosis of BCVI was confirmed by independent, blinded neuroradiologists prior to study inclusion. Demographics, injury mechanism and associated injuries of patients were extracted from the AHTR and patient medical records. There were 20,954 blunt trauma patients in the AHTR during the study period, of which 300 patients were confirmed to have 428 BCVIs. The incidence of BCVI was 1.4% (95%CI: 1.3–1.6). The mortality rate was 14% with a median survival time of 86 h from the time of injury. More men (65%) were diagnosed with BCVI than women and motor vehicle crashes (n = 180; 60%) were the most common mechanism of injury. Younger age, high transfer mechanisms, high injury severity, brain and chest trauma were associated with carotid artery injuries, while vertebral artery injuries were associated with older age, higher presenting GCS and cervical spinal injuries. The incidence of BCVI was low. The risk profile for patients with CAIs and VAIs were different. Consistent with the modified Denver criteria, high energy transfer mechanisms and cervical spinal injuries were identified to be high-risk features, but they impacted carotid and vertebral arteries differently. Any trauma involving these mechanisms should trigger investigation for the detection of BCVIs.","PeriodicalId":9553,"journal":{"name":"Burns & Trauma","volume":null,"pages":null},"PeriodicalIF":5.3,"publicationDate":"2023-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80934999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Burns & TraumaPub Date : 2023-07-18DOI: 10.1177/14604086231185990
F. Davies, M. O’Meara, C. Hudson
{"title":"Use of a Rapid Rhino in haemorrhage control for penetrating neck injury presenting in traumatic cardiac arrest","authors":"F. Davies, M. O’Meara, C. Hudson","doi":"10.1177/14604086231185990","DOIUrl":"https://doi.org/10.1177/14604086231185990","url":null,"abstract":"Penetrating neck injuries present as serious, life-threatening events which require advanced expeditious management if the patient is to survive without significant morbidity and mortality. In-hospital paradigms for high-volume centres include the use of Foley catheter balloon tamponade to temporarily or definitively control haemorrhage from carotid sheath structures, although these techniques are less commonly deployed in the field. We highlight the case of a 25-year-old male who presented to the ambulance service with three self-inflicted neck wounds – one to each of the zones of the neck. The zone 2 wound had transected the internal jugular vein and also the ipsilateral vertebral artery, causing severe haemorrhage leading to hypovolaemic cardiac arrest in a remote farmhouse location. He was treated with a modified tamponade technique, employing the use of a Rapid Rhino 900™ epistaxis catheter, secured with sutures into the zone 2 wound prior to inflation. This resulted in complete haemostasis, which allowed the patient to be volume resuscitated, anaesthetised and flown by air ambulance to the regional trauma centre. His injuries were treated and his recovery was interrupted only by a transient Horner's syndrome. This report showcases the first time this modification of a well-known in-hospital technique was deployed, which proved life-saving in this case and could be of use to others. We discuss the importance of catheter tamponade techniques as opposed to direct packing, in particular for those who need to be transported either within, between or to the hospital. This is in contradistinction to other authors advocating direct packing as the mainstay of treatment.","PeriodicalId":9553,"journal":{"name":"Burns & Trauma","volume":null,"pages":null},"PeriodicalIF":5.3,"publicationDate":"2023-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83999220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}