Survey on worldwide trauma team activation requirement

PURPOSE : trauma team activation (TTA) is thought to be essential for advanced and specialized care of very severely injured patients. However, non-specific TTA criteria may result in overtriage that consumes valuable resources or endanger patients in need of TTA secondary to undertriage. Consequently, criterion standard definitions to calculate the accuracy of the various TTA protocols are required for research and quality assurance purposes. Recently, several groups suggested a list of conditions when a trauma team is considered to be essential in the initial care in the emergency room. The objective of the survey was to post hoc identify trauma-related conditions that are thought to require a specialized trauma team that may be widely accepted, independent from the country’s income level. METHODS : A set of questions was developed, centered around the level of agreement with the proposed post hoc criteria to define adequate trauma team activation. The participants gave feedback before they answered the survey to improve the quality of the questions. The finalized survey was conducted using an online tool and a word form. The income per capita of a country was rated according to the World Bank Country and Lending groups. RESULTS : The return rate was 76% with a total of 37 countries participating. The agreement with the proposed criteria to define post hoc correct requirements for trauma team activation was more than 75% for 12 of the 20 criteria. The rate of disagreement was low and varied between zero and 13%. The level of agreement was independent from the country’s level of income. CONCLUSIONS : The agreement on criteria to post hoc define correct requirements for trauma team activation appears high and it may be concluded that the proposed criteria could be useful for most countries, independent from their level of income. Nevertheless, more discussions on an international level appear to be warranted to achieve a full consensus to define a universal set of criteria that will allow for quality assessment of over- and undertriage of trauma team activation as well as for the validation of field triage criteria for the most severely injured patients worldwide.http://link.springer.com/journal/68am2022Surger

Surgical Treatment of Radial Head Fractures: Review of Literature.

The aim of this systematic review was to search for and critically appraise articles directly comparing functional outcomes and complications for fixation (ORIF) versus arthroplasty for comminuted radial head fractures (Mason type 3) in adults. Material and methods: A comprehensive study of Medline, Embase and Cochrane databases using specific search terms and limits was conducted. Strict eligibility criteria were applied to stringently screen resultant articles. Three comparative studies were identified and reviewed. Results: Two studies found significantly better functional scores after replacement compared with ORIF in Mason type 3 fractures. The third study found no significant differences in functional score or range of motion, but did find that grip strength was better after ORIF. Complication rates were too heterogenous for conclusion. Conclusion: Fixation with good reduction may be attempted in unstable Mason type 3 fractures, and arthroplasty may be considered if this is not possible. Further randomised comparative trials are required to clarify the decision-making between fixation and replacement. Functional outcomes and complications were conflicting in the studies included here. Ideally, treatment decision should take into account elbow stability and degree of comminution

Damage Control Orthopedic Surgery.

The concept of damage control surgery was first described for the purpose of treating medically un-stable patients with abdominal trauma. The purpose of such surgery is rapid control of hemorrhage and contamination, not definitive repair of injuries. The goal is to improve survival of patients with the potentially lethal triad of hypothermia, acidosis and coagulopathy. Definitive repair of injuries and abdominal closure are not performed at the time of initial laparotomy. Rather, the abdominal wound is left open, a dressing is placed, and the patient is transported to the intensive care unit for continued re-suscitation. This includes optimization of hemodynamic condition, respiratory support, warming, and correction of coagulopathy. Following successful resuscitation, when the patient is medically stable, a return to the operating room is scheduled for repair of injuries and abdominal closure

Minimally Invasive Hallux Valgus Surgery. A Systematic Review

This systematic review aims to illustrate the published results of “minimally invasive” procedures for correction of hallux valgus. Based on former systematic reviews on that topic, the literature search was organised by two independent investigators. MEDLINE was systematically searched for available studies. The keywords used were “hallux valgus”, “bunion”, “percutaneous surgery”, “minimally invasive surgery”, “arthroscopy”, “Bosch” and “SERI”. Studies were assessed using the level of evidence rating. A total of 21 papers were included in this review. These studies described a total of 1,750 patients with 2,195 instances of percutaneous, minimally invasive or arthroscopic hallux valgus surgery. Clinical reports of results after minimally invasive hallux valgus surgery at meetings are common. Published results in peer-reviewed journals are less common and the majority of papers are level IV studies according to the level of evidence ratings. We found one level II and three level III studies. Reported complications seem to be less than one may see in one’s own clinical practice. This possible bias may be related to the fact that most studies are published by centres performing primarily minimally invasive hallux valgus surgery

The 6th Albanian Congress of Trauma and Emergency Surgery

After a three-year quarantine from the deadliest global pandemic of the last century, ASTES is organizing to gather all health professionals in Tirana, The 6th Albanian Congress of Trauma and Emergency Surgery(ACTES 2022) on 11-12 November 2022, with the topic Trauma & Emergency Surgery and not only...with the aim of providing high quality, the best standards, and the best results, for our patients ...ACTES 2022 is the largest event that ASTES (Albanian Society for Trauma and Emergency Surgery) has organized so far with 230 presentations, and 67 foreign lecturers with enviable geography, making it the largest national and wider scientific event.The scientific program is as strong as ever, thanks to the inclusiveness, where all the participants with a mix of foreign and local lecturers, select the best of the moment in medical science, innovation, and observation.The scientific committee has selected all the presentations so that the participants of each medical discipline will have something to learn, discuss, debate, and agree with updated methods, techniques, and protocols.I hope you will join us on Friday morning, and continue the journey of our two-day event together