- The Effects of a Trauma Team Approach on the Management of Open Extremity Fractures in Polytrauma Patients: A Retrospective Comparative Study
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Seungyeob Sakong, Eic Ju Lim, Jun-Min Cho, Nak-Jun Choi, Jae-Woo Cho, Jong-Keon Oh
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J Trauma Inj. 2021;34(2):105-111. Published online March 15, 2021
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DOI: https://doi.org/10.20408/jti.2020.0043
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Abstract
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- Purpose
Open extremity fractures require prompt antibiotic medication and initial debridement surgery to reduce the infection rate and restore functional stabilization. We aimed to report the effects and positive outcomes of a trauma team approach on the management of open extremity fractures in polytrauma patients.
Methods
This retrospective review included all polytrauma patients with open extremity fractures admitted between March 2009 and December 2019. Patients were divided into two groups according to whether they were treated before or after the implementation of the trauma team approach (March 2014). We analyzed the outcomes in each group with respect to the time interval until the doctor’s arrival, total length of stay in the emergency department, the time interval until initial antibiotic treatment and operation, whether the initial operation was performed within 24 hours, and the rate of deep infections.
Results
A total of 123 patients met the inclusion criteria. There were no statistically significant differences in demographic characteristics. The time interval until the doctor’s arrival (64.12±49.2 minutes vs. 19.82±15.23 minutes; p=0.035) and initial antibiotic treatment (115.47±72.12 minutes vs. 48.78±30.12 minutes; p=0.023) significantly improved after implementing the trauma team approach. The union rate was not significantly different. However, the time interval until initial debridement, opportunity for initial debridement within 24 hours, and the rate of deep infections demonstrated better results.
Conclusions
The reduced time interval until initial antibiotic treatment and debridement could be attributed to the positive effect of the trauma team approach on the management of open extremity fractures in polytrauma patients.
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Summary
- Hemorrhagic Shock in a Patient with a Morel-Lavallée Lesion Combined with Active Arterial Bleeding without Fracture
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Eic Ju Lim, Jong-Keon Oh, Jae-Woo Cho, Seungyeob Sakong, Jun-Min Cho
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J Trauma Inj. 2021;34(1):61-65. Published online November 30, 2020
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DOI: https://doi.org/10.20408/jti.2020.0013
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Abstract
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A Morel-Lavallée lesion is a closed degloving injury caused by traumatic separation of the skin and subcutaneous tissue from the underlying fascia. However, since physicians tend to focus on treating the bone fracture, hemodynamic instability accompanying a Morel-Lavallée lesion can sometimes be overlooked. We report the case of a hemodynamically unstable 73-year-old man who had a Morel-Lavallée lesion of the thigh, but no femur fracture. Angiography showed active bleeding from the muscular branch of the right deep femoral artery, which was then successfully embolized.
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Summary
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