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Volume 32(4); December 2019
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Original Articles
Cranioplasty Results after the Use of a Polyester Urethane Dural Substitute (Neuro-Patch®) as an Adhesion Prevention Material in Traumatic Decompressive Craniectomy
Tae Seok Jeong, Woo Kyung Kim, Myung Jin Jang
J Trauma Inj. 2019;32(4):195-201.   Published online December 30, 2019
DOI: https://doi.org/10.20408/jti.2019.030
  • 3,594 View
  • 85 Download
  • 1 Citations
AbstractAbstract PDF
Purpose

This study was conducted to investigate the usefulness of a polyester urethane dural substitute (Neuro-Patch®, B. Braun, Boulogne, France) as an anti-adhesion agent in subsequent cranioplasty by analyzing the use of Neuro-Patch® during decompressive craniectomy in traumatic brain injury patients.

Methods

We retrospectively analyzed patients with traumatic brain injury who underwent decompressive craniectomy followed by cranioplasty from January 2015 to December 2018. Patients were analyzed according to whether they received treatment with Neuro-Patch® or not (Neuro-Patch® group, n=71; control group, n=55). Patients’ baseline characteristics were analyzed to identify factors that could affect cranioplasty results, including age, sex, hypertension, diabetes mellitus, use of antiplatelet agents or anticoagulant medication, the interval between craniectomy and cranioplasty, and the type of bone used in cranioplasty. The cranioplasty results were analyzed according to the following factors: operation time, blood loss, postoperative hospitalization period, surgical site infection, and revision surgery due to extra-axial hematoma.

Results

No significant difference was found between the two groups regarding patients’ baseline characteristics. For the cranioplasty procedures, the operation time (155 vs. 190 minutes, p=0.003), intraoperative blood loss (350 vs. 450 mL, p=0.012), and number of surgical site infections (4 vs. 11 cases, p=0.024) were significantly lower in the Neuro-Patch® group than in the control group.

Conclusions

The use of Neuro-Patch® was associated with a shorter operation time, less blood loss, and a lower number of surgical site infections in subsequent cranioplasties. These results may provide a rationale for prospective studies investigating the efficacy of Neuro-Patch®.

Summary

Citations

Citations to this article as recorded by  
  • Efficacy and safety of decompressive craniectomy with non-suture duraplasty in patients with traumatic brain injury
    Tae Seok Jeong, Gi Taek Yee, Tae Gyu Lim, Woo Kyung Kim, Chan Jong Yoo, Giovanni Grasso
    PLOS ONE.2020; 15(10): e0232561.     CrossRef
Outcomes of Cranioplasty Using Autologous Bone or 3D-Customized Titanium Mesh Following Decompressive Craniectomy for Traumatic Brain Injury: Differences in Complications
Junwon Kim, Jang Hun Kim, Jong Hyun Kim, Taek-Hyun Kwon, Haewon Roh
J Trauma Inj. 2019;32(4):202-209.   Published online December 30, 2019
DOI: https://doi.org/10.20408/jti.2019.033
  • 5,458 View
  • 99 Download
  • 6 Citations
AbstractAbstract PDF
Purpose

Cranioplasty (CP) is often required for survival after decompressive craniectomy. Several materials, including autologous bone and various artificial materials, have been introduced for CP, but it remains unclear which material is best for CP. This study aimed to explore differences in complications between patients who underwent CP using an autologous bone flap versus a three-dimensional (3D) titanium mesh and to identify significant risk factors for post-CP complications.

Methods

In total, 44 patients were enrolled in this study and divided into two groups (autologous bone vs. 3D titanium mesh). In both groups, various post-CP complications were evaluated. Through a comparative analysis, we aimed to identify differences in complications between the two groups and, using binary logistic analysis, to determine significant factors associated with complications after CP.

Results

In the autologous bone flap group, there were three cases of surgical infection (3/24, 12.5%) and 11 cases of bone flap resorption (BFR) (11/24, 45.83%). In the 3D titanium mesh group, there was only one case of surgical infection (1/20, 5%) and 11 cases of various complications, including mainly cosmetic issues (11/20, 55%). A subgroup risk factor analysis of CP with an autologous bone flap showed no risk factors that predicted BFR with statistical significance, although a marginal association was found between larger bone flaps and BFR (odds ratio [OR]=1.037, p=0.090). In patients treated with a 3D titanium mesh, multivariate analysis revealed that only the existence of a ventriculo-peritoneal shunt system was strongly associated with overall post-CP complications (OR=18.66, p=0.021).

Conclusions

Depending on which material was used, different complications could occur, and the rate of complications was relatively high in both groups. Hence, the material selected for CP should be selected based on individual patients’ conditions.

Summary

Citations

Citations to this article as recorded by  
  • Customized Additive Manufacturing in Bone Scaffolds—The Gateway to Precise Bone Defect Treatment
    Juncen Zhou, Carmine Wang See, Sai Sreenivasamurthy, Donghui Zhu
    Research.2023;[Epub]     CrossRef
  • Customized cost-effective polymethylmethacrylate cranioplasty: a cosmetic comparison with other low-cost methods of cranioplasty
    Manish Baldia, Mathew Joseph, Suryaprakash Sharma, Deva Kumar, Ashwin Retnam, Santosh Koshy, Reka Karuppusami
    Acta Neurochirurgica.2022; 164(3): 655.     CrossRef
  • Letter to the Editor: Complications following titanium cranioplasty compared with nontitanium implants cranioplasty: A systematic review and meta-analysis
    Michael Amoo, Jack Henry
    Journal of Clinical Neuroscience.2021; 87: 32.     CrossRef
  • Complications of Cranioplasty in Relation to Material: Systematic Review, Network Meta-Analysis and Meta-Regression
    Jack Henry, Michael Amoo, Joseph Taylor, David P O’Brien
    Neurosurgery.2021; 89(3): 383.     CrossRef
  • Comparison of complications in cranioplasty with various materials: a systematic review and meta-analysis
    Liming Liu, Shou-Tao Lu, Ai-Hua Liu, Wen-Bo Hou, Wen-Rui Cao, Chao Zhou, Yu-Xia Yin, Kun-Shan Yuan, Han-Jie Liu, Ming-Guang Zhang, Hai-Jun Zhang
    British Journal of Neurosurgery.2020; 34(4): 388.     CrossRef
  • A Reappraisal of the Necessity of a Ventriculoperitoneal Shunt After Decompressive Craniectomy in Traumatic Brain Injury
    Seunghan Yu, Hyuk Jin Choi, Jung Hwan Lee, Mahnjeong Ha, Byung Chul Kim
    Journal of Trauma and Injury.2020; 33(4): 236.     CrossRef
Comparison of Penetrating and Blunt Traumatic Diaphragmatic Injuries
Sang Su Lee, Sung Youl Hyun, Hyuk Jun Yang, Yong Su Lim, Jin Seong Cho, Jae Hyug Woo
J Trauma Inj. 2019;32(4):210-219.   Published online December 30, 2019
DOI: https://doi.org/10.20408/jti.2019.034
  • 4,127 View
  • 96 Download
  • 2 Citations
AbstractAbstract PDF
Purpose

Traumatic diaphragmatic injury (TDI) is no longer considered to be a rare condition in Korea. This study investigated differences in the prevalence of accompanying injuries and the prognosis in patients with traumatic diaphragmatic damage according to the mechanism of injury.

Methods

We retrospectively reviewed the medical records of patients with TDI who were seen at a regional emergency medical center from January 2000 to December 2018. Among severe trauma patients with traumatic diaphragmatic damage, adults older than 18 years of age with a known mechanism of injury were included in this study. Surgery performed within 6 hours after the injury was sustained was defined as emergency surgery. We assessed the survival rate and likelihood of respiratory compromise according to the mechanism of injury.

Results

In total, 103 patients were analyzed. The patients were categorized according to whether they had experienced a penetrating injury or a blunt injury. Thirty-five patients had sustained a penetrating injury, and traffic accidents were the most common cause of blunt injuries. The location of the injury did not show a statistically significant difference between these groups. Severity of TDI was more common in the blunt injury group than in the penetrating injury group, and was also more likely in patients with respiratory compromise. However, sex, the extent of damage, and the initial Glasgow coma scale score had no significant relationship with severity.

Conclusions

Based on the findings of this study, TDI should be recognized and managed proactively in patients with blunt injury and/or respiratory compromise. Early recognition and implementation of an appropriate management strategy would improve patients’ prognosis. Multi-center, prospective studies are needed in the future.

Summary

Citations

Citations to this article as recorded by  
  • An audit of traumatic haemothoraces in a regional hospital in KwaZulu-Natal, South Africa
    CM Kithuka, VC Ntola, W Sibanda
    South African Journal of Surgery.2023; 61(3): 12.     CrossRef
  • Factors Associated with Successful Video-Assisted Thoracoscopic Surgery and Thoracotomy in the Management of Traumatic Hemothorax
    Heather M. Grant, Alexander Knee, Michael V. Tirabassi
    Journal of Surgical Research.2022; 269: 83.     CrossRef
The Timing of Femur Fracture Fixation is an Important Factor for Prolonged Mechanical Ventilation
Hyung Chul Choi, Kwang Hwan Jung, Kyu Hyouck Kyoung, Seong Ho Choi
J Trauma Inj. 2019;32(4):220-225.   Published online December 30, 2019
DOI: https://doi.org/10.20408/jti.2019.028
  • 3,076 View
  • 42 Download
  • 1 Citations
AbstractAbstract PDF
Purpose

Mechanical ventilation (MV) is an essential life-saving modality for severely injured patients. However, the long-term use of MV is a major risk factor for late mortality. The surgical correction of long bone fractures plays a critical role not only in improving functional outcomes, but also in reducing physiological derangements, including MV duration. This study investigated the factors affecting prolonged MV (PMV) in severely injured patients with femur fractures.

Methods

We retrospectively evaluated all severely injured patients (injury severity score >15) with femur fractures who were taken to the emergency department within 12 hours of the causative accidents between January 2016 and December 2018. PMV was defined as MV lasting for ≥7 days. We analyzed the factors affecting PMV.

Results

In total, 35 patients were enrolled and 21 (33.3%) were included in the PMV group. The PMV group required more red blood cell (RBC) transfusions within 7 days RBC (7dRBC) (12.8 vs. 6.8 units; p=0.03) and the time to femur fracture fixation (TFFF) was longer (7.9 vs. 2.7 days; p=0.018). The area under the curve (AUC) for TFFF was 0.740 (95% confidence interval [CI]: 0.572–0.908; p=0.018) and the AUC for 7dRBC was 0.718 (95% CI: 0.546–0.889; p=0.031).

Conclusions

This study indicates that TFFF is an independent risk factor for PMV. Early fixation of femur fractures might prevent PMV and its associated complications.

Summary

Citations

Citations to this article as recorded by  
  • Management of Traumatic Femur Fractures: A Focus on the Time to Intramedullary Nailing and Clinical Outcomes
    Syed Imran Ghouri, Fuad Mustafa, Ahad Kanbar, Hisham Al Jogol, Adam Shunni, Ammar Almadani, Nuri Abdurraheim, Atirek Pratap Goel, Husham Abdelrahman, Elhadi Babikir, Ahmed F. Ramzee, Khalid Ahmed, Mutaz Alhardallo, Mohammad Asim, Hassan Al-Thani, Ayman El
    Diagnostics.2023; 13(6): 1147.     CrossRef
Gender and Intentionality Disparities in the Epidemiology and Outcomes of Falls from Height in Korean Adults
Seung Uk Han, Sun Pyo Kim, Sun Hyu Kim, Gyu Chong Cho, Min Joung Kim, Ji Sook Lee, Chul Han
J Trauma Inj. 2019;32(4):226-237.   Published online December 30, 2019
DOI: https://doi.org/10.20408/jti.2019.020
  • 3,310 View
  • 45 Download
  • 1 Citations
AbstractAbstract PDF
Purpose

This study investigated the characteristics of adult patients who had fallen from a height and presented to an emergency room (ER) according to gender and intentionality, with the goal of reducing the harm caused by these injuries.

Methods

A retrospective analysis was conducted of fall-from-height patients aged ≥19 years from the in-depth surveillance study of injured patients visiting ERs conducted under the supervision of the Korea Centers for Disease Control and Prevention from 2011 to 2016. Patterns were analyzed according to gender and intentionality.

Results

There were 29,838 men (68.5%) and 13,734 women (31.5%), with mean ages of 50.3±15.7 years and 57.2±19.9 years, respectively. The most common height of the fall was ≥1 m to 4 m in men (n=15,863; 53.2%) and <1 m in women (n=7,293; 53.1%). The most common location where the fall occurred was the workplace for men (n=10,500 male; 35.2%) and residential facilities for women (n=7,755; 56.5%). Most falls from height were unintentional (n=41,765; 97.1% vs. n=1,264; 2.9% for intentional falls). Suicide was the most frequent reason for intentional falls, and the age group of 19–30 years predominated in this category (n=377; 29.9%). For intentional falls, the most common interval before presentation to the ER was 0–6 hours (n=370; 29.3%) and the most common height was ≥4 m (n=872; 69.0%).

Conclusions

Among men, falls from height most often occurred from ≥1 m to 4 m, at the workplace, and during the course of paid work, whereas among women, they were most common from <1 m, in residential facilities, and during daily activities. Intentional falls most often occurred with the purpose of suicide, in the age group of 19–30 years, with an interval of 0–6 hours until treatment, from ≥4 m, and in residential facilities. Alcohol consumption was more common in intentional falls.

Summary

Citations

Citations to this article as recorded by  
  • Acil Serviste Yaralanmaların Demografik Analizi ve Niyetselliği
    Mustafa AÇİN, Halit KARAKISA, Salim SATAR
    Phoenix Medical Journal.2020; 2(3): 152.     CrossRef
Case Reports
Resuscitation from a pH of 6.5: A Case Report and Review of Pathophysiology and Management of Extreme Acidosis from Hypovolemic Shock after Trauma
Alexander Balmaceda, Sona Arora, Ilan Sondheimer, McKenzie M. Hollon
J Trauma Inj. 2019;32(4):238-242.   Published online December 30, 2019
DOI: https://doi.org/10.20408/jti.2019.029
  • 14,608 View
  • 368 Download
  • 3 Citations
AbstractAbstract PDF

Extreme acidosis is a life-threatening physiological state that causes disturbances in the cardiovascular, pulmonary, immune, and hematological systems. Trauma patients commonly present to the operating room (OR) in hypovolemic shock, leading to tissue hypoperfusion and the development of acute metabolic acidosis with or without a respiratory component. It is often believed that trauma patients presenting to the OR in severe metabolic acidosis (pH <7.0) will have a nearly universal mortality rate despite aggressive resuscitation and damage control. The current literature does not include reports of successful resuscitations from a lower pH, which may lead providers to assume that a good outcome is not possible. However, here we describe a case of successful resuscitation from an initial pH of 6.5 with survival to discharge home 95 days after admission with almost full recovery. We describe the effects of acute acidosis on the respiratory and cardiovascular systems and hemostasis. Finally, we discuss the pillars of management in patients with extreme acute acidosis due to hemorrhage: transfusion, treatment of hyperkalemia, and consideration of buffering acidosis with bicarbonate and hyperventilation.

Summary

Citations

Citations to this article as recorded by  
  • Prognosis of patients with extreme acidosis on admission to the emergency department: A retrospective cohort study
    Amichai Gutgold, Shaden Salameh, Jeries Nashashibi, Yonatan Gershinsky
    The American Journal of Emergency Medicine.2024; 76: 36.     CrossRef
  • Thoracotomy Resuscitation of a Patient Who Sustained Blunt Force Trauma with a pH of 6.7 on Admission and Ultra Massive Transfusion of 42 Units of Blood
    John T. Meghreblian, A. J. Bethurum, Lou M. Smith
    The American Surgeon™.2024;[Epub]     CrossRef
  • Successful Outcomes of Critically Ill Patients with Extreme Metabolic Acidosis Treated with Structured Approach: Case Series
    Sasa Dragic, Danica Momcicevic, Biljana Zlojutro, Milka Jandric, Tijana Kovacevic, Vlado Djajic, Ognjen Gajic, Pedja Kovacevic
    Clinical Medicine Insights: Case Reports.2021; 14: 117954762110251.     CrossRef
Delayed Subclavian Vein Stenosis without Thrombosis Following Clavicle Fracture
Do Wan Kim, In Seok Jeong, Kook Joo Na
J Trauma Inj. 2019;32(4):243-247.   Published online December 30, 2019
DOI: https://doi.org/10.20408/jti.2019.024
  • 3,576 View
  • 52 Download
AbstractAbstract PDF

Subclavian vein injuries occasionally occur as a sequela of penetrating trauma or vascular access, but have rarely been reported to occur after clavicle fracture. The subclavian vessels are mainly enclosed by the subclavius muscle, the first rib, and the costocoracoid ligament. Therefore, in such cases, subclavian vein injury is rare because of the strcutures surrounding the subclavian vessels. Nevertheless, subclavian vein injuries occasionally show thrombotic manifestations, and thrombosis of the upper limbs constitutes 1–4% of cases of total deep vein thrombosis. Furthermore, to the best of the authors’ knowledge, although vessel injuries have been reported after clavicle or rib fractures and nerve injuries to regions such as the brachial plexus, no case involving delayed presentation of isolated subclavian vein stenosis after clavicle fracture due to blunt trauma has yet been reported.

Summary
Chronic Traumatic Glass Foreign Body Removal from the Lung through a Direct Parenchymal Incision
Su Young Yoon, Si Wook Kim, Jin Suk Lee, Jin Young Lee, Jin Bong Ye, Se Heon Kim, Young Hoon Sul
J Trauma Inj. 2019;32(4):248-251.   Published online December 30, 2019
DOI: https://doi.org/10.20408/jti.2019.031
  • 3,906 View
  • 57 Download
  • 1 Citations
AbstractAbstract PDF

Traumatic intrapulmonary glass foreign bodies that are missed on an initial examination can migrate and lead to severe complications. Here, we present a rare case of a traumatic intrapulmonary glass foreign body surgically removed by a direct pulmonary incision, which preserved the pulmonary parenchyma and avoided severe complications caused by migration.

Summary

Citations

Citations to this article as recorded by  
  • Thoracoscopic retrieval of an intrapulmonary sewing needle: A case report
    Houssem Messaoudi, Imen Ben Ismail, Wafa Ragmoun, Hatem Lahdhili, Saber Hachicha, Slim Chenik
    Clinical Case Reports.2020; 8(12): 2494.     CrossRef
A Carbon Monoxide Poisoning Case in Which Hyperbaric Oxygen Therapy Was Not Possible Due to Iatrogenic Pneumothorax after Unnecessary Central Catheterization
Hyung Il Kim, Seong Beom Oh
J Trauma Inj. 2019;32(4):252-257.   Published online December 30, 2019
DOI: https://doi.org/10.20408/jti.2019.040
  • 3,793 View
  • 48 Download
AbstractAbstract PDF

Hyperbaric oxygen therapy (HBOT) is used to treat carbon monoxide (CO) poisoning. However, untreated pneumothorax is an absolute contraindication for HBOT. More caution is needed with regard to monoplace hyperbaric chambers, as patient monitoring and life-saving procedures are impossible inside these chambers. Central catheterization is frequently used for various conditions, but unnecessary catheterization must be avoided because of the risk of infection and mechanical complications. Herein, we describe a case of CO poisoning in which iatrogenic pneumothorax developed after unnecessary subclavian central catheterization. The patient did not need to be catheterized, and HBOT could not be performed because of the pneumothorax. Hence, this case reminds us of basic—but nonetheless important—principles of catheterization.

Summary
Editorial
Comments on “Case Series: Successful Resuscitation of Severe Facial Injuries Caused by a Chainsaw”
Kun Hwang
J Trauma Inj. 2019;32(4):258-259.   Published online December 30, 2019
DOI: https://doi.org/10.20408/jti.2019.038
  • 2,872 View
  • 32 Download
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Summary

J Trauma Inj : Journal of Trauma and Injury