Penetrating injuries in dogs and cats: a study of 16 cases

The objective of this retrospective study was to assess radiographical and surgical findings, surgical management and outcome of penetrating injuries in dogs and cats by evaluating patient records. Sixteen patients were identified (15 dogs and one cat), four with gunshot wounds, and 12 with fight wounds (11 with bite wounds, one struck by a claw). The thoracic cavity was affected in six patients, the abdominal cavity in three cases. Both cavities were affected in five dogs and the trachea in two cases. All of the patients with fight wounds were small breed dogs. Multiple injuries to internal organs that required intervention were found surgically after gunshot wounds and a high amount of soft tissue trauma requiring reconstruction was present after fight wounds. Radiography diagnosed body wall disruption in two cases. All of the affected thoracic body walls in the fight group had intercostal muscle disruptions which was diagnosed surgically. Fourteen patients survived until discharge and had a good outcome. In conclusion, penetrating injuries should be explored as they are usually accompanied by severe damage to either the internal organs or to the body wall. A high level of awareness is required to properly determine the degree of trauma of intercostal muscle disruption in thoracic fight wounds

Critical-Sized Bone Defects: Sequence and Planning.

Bone defects associated with open fractures require a careful approach and planning. At initial presentation, an emergent irrigation and debridement is required. Immediate definitive fixation is frequently safe, with the exception of those injuries that normally require staged management or very severe type IIIB and IIIC injuries. Traumatic wounds that can be approximated primarily should be closed at the time of initial presentation. Wounds that cannot be closed should have a negative pressure wound therapy dressing applied. The need for subsequent debridements remains a clinical judgment, but all nonviable tissue should be removed before definitive coverage. Cefazolin remains the standard of care for all open fractures, and type III injuries also require gram-negative coverage. Both induced membrane technique with staged bone grafting and distraction osteogenesis are excellent options for bony reconstruction. Soft tissue coverage within 1 week of injury seems critical

Pertolongan Pertama pada Luka Kena Pisau

The incidence of injuries is increasing every year, both acute wounds and chronic wounds. A recent study in America showed that the prevalence of patients with wounds was 3.50 per 1000 population. The majority of wounds in the world's population are wounds due to surgery/trauma (48.00%), foot ulcers (28.00%), decubitus wounds (21.00%). In 2009, MedMarket Diligence, a wound association in America conducted research on the incidence of wounds in the world based on disease etiology. Data obtained for surgical wounds were 110.30 million cases, trauma wounds 1.60 million cases, abrasions there were 20.40 million cases, burns 10 million cases, decubitus ulcers 8.50 million cases, venous ulcers 12.50 million cases, diabetic ulcers 13.50 million cases, amputations 0.20 million per year, carcinoma 0.60 million per year, melanoma 0.10 million, skin cancer complications there are 0.10 million cases. Injuries that occur in all our daily activities. Abrasions due to falls, injuries from sharp objects such as knives, nails and so on are considered minor injuries

Fabricated or Assault Wounds - A Scientific Approach

Background: Fabricated (fictitious, forged or invented) wounds are usually superficial injuries mostly produced by a person on his own body (self-inflicted) or occasionally, caused by another person acting in agreement with him (self-suffered). Assault means a physical attack by another person.Case Report: We received two cases, within a short period, from different police stations, with multiple incised wounds over different regions of the body. Characteristically one of the cases was brought with all fresh wounds and another with all healed linear scar marks. Both these cases were presented as assault wounds in the hospital. As the history of both cases was misleading and the investigating authority was suspecting fabricated wounds, medical opinion regarding the manner of injuries was sought.Conclusion: Present case report deals with importance of proper history taking, pattern of injuries, examination and use of simple techniques like photography and hand lens to rule out assault wounds

Pattern of defence injuries among homicidal victims

AbstractExamination of defence wounds in homicidal victims is of immense importance to the autopsy surgeon. Based on the presence of such injuries it can be opined that the victim was conscious, could comprehend the attack and provided resistance during the assault. The type of injury sustained also gives an idea regarding the weapon of offence. Out of the 189 homicidal deaths during the 5-year period of study, defence wounds were noted in 90 cases. Most of the wounds were sustained by males in the age group of 30–44years. Incised wounds (52.2%) were the most common type of defence wounds followed by chop wounds and abrasions. In 70% of cases the injuries were on one side of the body, the left side being more common. The forearm and the hand were the most affected parts. A careful and thorough examination is necessary to rule out fabricated wounds being misinterpreted as defence wounds

Surgical treatment of combat craniocerebral gunshot wounds combined with paranasal sinuses injury

Abstract. Results of surgical treatment of 30 patients with combat-related gunshot traumatic brain injuries (GTBI) combined with paranasal sinuses injury (PNS) were analyzed. The injuries resulted from local armed conflict in the Eastern Ukraine. Object and methods. The patients were consistently enrolled in the prospective study in the period from May 25, 2014 to December 31, 2017. This group of patients made up 16.3% of all GTBI patients treated during that period. All patients underwent high-resolution cranial CT at admission. Frontal sinus injuries were observed in 25 (83%) cases; ethmoid bone injuries, in 13 (43) cases; sphenoidal sinus injuries, in 1 (3%) case. 26 (87%) patients had penetrating wounds; 4 (13%) patients, non-penetrating cerebral wounds. Fragment mine blast wounds were observed in 26 (87%) cases; 4 (13.3%) wounds were caused by bullets. Blunt wounds were diagnosed in 17 (57%) patients; bound shot wounds, in 7 (23%) patients; penetrating wounds, in 6 (20%) patients. GCS score after initial resuscitation ranged from 5 to 15 (average 10.6±3.5). Four non-penetrating brain wound patients were treated conservatively. Initially, 26 (87%) patients underwent surgery. Emergency intervention was performed to remove intracranial hematoma, close dura mater defects and restore skull base while simultaneously sealing ethmoid and frontal air sinuses. Well-vascularized frontal and lateral pericranial flaps on pedicle in various modifications were used to close frontal sinus and anterior cranial fossa defects. Outcomes. Nasal liquorrhea was observed in 12 (40%) patients at admission and in 2 (7%) patients after treatment. Purulent and septic complications were only detected in 1 (3%) patient. The complications had the form of combined meningoencephalitis, ventriculitis, and subdural empyema. Favourable treatment outcomes (good recovery or moderate disability) in 6 months after treatment were detected in 24 (80%) patients; unfavourable outcomes (severe disability or death), in 6 (20%) patients. Vegetative state was not observed in treated patients. Two lethal cases were not associated with paranasal sinus injury. In one case, there was a severe primary brain injury; in the other case, severe combined internal organ injuries with multiple organ failure

Stab wounds in Bulawayo, Zimbabwe: a four year audit

A CAJM journal article.Outside South Africa the problem of stab wounds has not received much attention in the African medical literature. This problem has not been studied before in Zimbabwe. From a review of the literature, supported by the material in this paper, it is clear, that most stab wounds affect the chest and abdomen. Clinicians should therefore be aware of the various management options of such injuries. This study was carried out to determine the pattern of stab wounds in our practice and to analyze the results of our management of patients with such injuries. The relevant literature is reviewed and suggestions are made to bring our management of stab wounds in line with current management trends

Penetrating Abdominal Injuries: Management Controversies

Penetrating abdominal injuries have been traditionally managed by routine laparotomy. New understanding of trajectories, potential for organ injury, and correlation with advanced radiographic imaging has allowed a shift towards non-operative management of appropriate cases. Although a selective approach has been established for stab wounds, the management of abdominal gunshot wounds remains a matter of controversy. In this chapter we describe the rationale and methodology of selecting patients for non-operative management. We also discuss additional controversial issues, as related to antibiotic prophylaxis, management of asymptomatic thoracoabdominal injuries, and the use of colostomy vs. primary repair for colon injuries

Metals detected by ICP/MS in wound tissue of war injuries without fragments in Gaza

<p>Abstract</p> <p>Background</p> <p>The amount and identity of metals incorporated into "weapons without fragments" remain undisclosed to health personnel. This poses a long-term risk of assumption and contributes to additional hazards for victims because of increased difficulties with clinical management. We assessed if there was evidence that metals are embedded in "wounds without fragments" of victims of the Israeli military operations in Gaza in 2006 and 2009.</p> <p>Methods</p> <p>Biopsies of "wounds without fragments" from clinically classified injuries, amputation (A), charred (C), burns (B), multiple piercing wounds by White Phosphorus (WP) (M), were analyzed by ICP/MS for content in 32 metals.</p> <p>Results</p> <p>Toxic and carcinogenic metals were detected in folds over control tissues in wound tissues from all injuries: in A and C wounds (Al, Ti, Cu, Sr, Ba, Co, Hg, V, Cs and Sn), in M wounds (Al, Ti, Cu, Sr, Ba, Co and Hg) and in B wounds (Co, Hg, Cs, and Sn); Pb and U in wounds of all classes; B, As, Mn, Rb, Cd, Cr, Zn in wounds of all classes, but M; Ni was in wounds of class A. Kind and amounts of metals correlate with clinical classification of injuries, exposing a specific metal signature, similar for 2006 and 2009 samples.</p> <p>Conclusions</p> <p>The presence of toxic and carcinogenic metals in wound tissue is indicative of the presence in weapon inducing the injury. Metal contamination of wounds carries unknown long term risks for survivors, and can imply effects on populations from environmental contamination. We discuss remediation strategies, and believe that these data suggest the need for epidemiological and environmental surveys.</p

Penetrating abdominal injuries: management controversies

Penetrating abdominal injuries have been traditionally managed by routine laparotomy. New understanding of trajectories, potential for organ injury, and correlation with advanced radiographic imaging has allowed a shift towards non-operative management of appropriate cases. Although a selective approach has been established for stab wounds, the management of abdominal gunshot wounds remains a matter of controversy. In this chapter we describe the rationale and methodology of selecting patients for non-operative management. We also discuss additional controversial issues, as related to antibiotic prophylaxis, management of asymptomatic thoracoabdominal injuries, and the use of colostomy vs. primary repair for colon injuries