INTRODUCTION: Nowadays we are facing a steep increase in non-operative management throughout the injured body areas, with a continuous increase in the injuries' grade. OBJECTIVE: To evaluate the safety and applicability of non-operative management in major trauma patients. METHODS: Prospective observational study, in a level I trauma center, during 30 months. INCLUSION CRITERIA: major trauma patients with abdominal visceral lesions. RESULTS: There were 207 major trauma patients whose average age was 35.8 ± 17.2 years, male being 69.6%. The most severe abdominal injuries were in the spleen (32.9%), the liver (19.2%) and the small bowel (11.6%). For the spleen lesions, the non-operative management was successful in 57.9% cases , with a failure rate of 11.6%. Non operative management was successful in 50% of liver injuries, its rate of success being independent of the hepatic injury grade. CONCLUSIONS: Selective non operative management of abdominal visceral injuries is safe and effective in major trauma patients. Nevertheless, we should stress that this type of protocol should be applied only by highly trained surgeons, able to early convert this management to difficult surgical strategies.
INTRODUCTION: Nowadays we are facing a steep increase in non-operative management throughout the injured body areas, with a continuous increase in the injuries' grade. OBJECTIVE: To evaluate the safety and applicability of non-operative management in major traumapatients. METHODS: Prospective observational study, in a level I trauma center, during 30 months. INCLUSION CRITERIA: major traumapatients with abdominal visceral lesions. RESULTS: There were 207 major traumapatients whose average age was 35.8 ± 17.2 years, male being 69.6%. The most severe abdominal injuries were in the spleen (32.9%), the liver (19.2%) and the small bowel (11.6%). For the spleen lesions, the non-operative management was successful in 57.9% cases , with a failure rate of 11.6%. Non operative management was successful in 50% of liver injuries, its rate of success being independent of the hepatic injury grade. CONCLUSIONS: Selective non operative management of abdominal visceral injuries is safe and effective in major traumapatients. Nevertheless, we should stress that this type of protocol should be applied only by highly trained surgeons, able to early convert this management to difficult surgical strategies.
Authors: Gwendolyn M van der Wilden; George C Velmahos; Timothy Emhoff; Samielle Brancato; Charles Adams; Georgios Georgakis; Lenworth Jacobs; Ronald Gross; Suresh Agarwal; Peter Burke; Adrian A Maung; Dirk C Johnson; Robert Winchell; Jonathan Gates; Walter Cholewczynski; Michael Rosenblatt; Yuchiao Chang Journal: Arch Surg Date: 2012-05
Authors: Henrik Petrowsky; Susanne Raeder; Lucia Zuercher; Andreas Platz; Hans Peter Simmen; Milo A Puhan; Marius J Keel; Pierre-Alain Clavien Journal: World J Surg Date: 2012-02 Impact factor: 3.352
Authors: Joseph Chen; Bryn Brazile; Raj Prabhu; Sourav S Patnaik; Robbin Bertucci; Hongjoo Rhee; M F Horstemeyer; Yi Hong; Lakiesha N Williams; Jun Liao Journal: J Biomech Eng Date: 2018-07-01 Impact factor: 2.097
Authors: Federico Coccolini; Giulia Montori; Fausto Catena; Yoram Kluger; Walter Biffl; Ernest E Moore; Viktor Reva; Camilla Bing; Miklosh Bala; Paola Fugazzola; Hany Bahouth; Ingo Marzi; George Velmahos; Rao Ivatury; Kjetil Soreide; Tal Horer; Richard Ten Broek; Bruno M Pereira; Gustavo P Fraga; Kenji Inaba; Joseph Kashuk; Neil Parry; Peter T Masiakos; Konstantinos S Mylonas; Andrew Kirkpatrick; Fikri Abu-Zidan; Carlos Augusto Gomes; Simone Vasilij Benatti; Noel Naidoo; Francesco Salvetti; Stefano Maccatrozzo; Vanni Agnoletti; Emiliano Gamberini; Leonardo Solaini; Antonio Costanzo; Andrea Celotti; Matteo Tomasoni; Vladimir Khokha; Catherine Arvieux; Lena Napolitano; Lauri Handolin; Michele Pisano; Stefano Magnone; David A Spain; Marc de Moya; Kimberly A Davis; Nicola De Angelis; Ari Leppaniemi; Paula Ferrada; Rifat Latifi; David Costa Navarro; Yashuiro Otomo; Raul Coimbra; Ronald V Maier; Frederick Moore; Sandro Rizoli; Boris Sakakushev; Joseph M Galante; Osvaldo Chiara; Stefania Cimbanassi; Alain Chichom Mefire; Dieter Weber; Marco Ceresoli; Andrew B Peitzman; Liban Wehlie; Massimo Sartelli; Salomone Di Saverio; Luca Ansaloni Journal: World J Emerg Surg Date: 2017-08-18 Impact factor: 5.469