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Role of laparoscopy in penetrating abdominal trauma: a systematic review

Bibliographic details: O'Malley E, Boyle E, O'Callaghan A, Coffey JC, Walsh SR.  Role of laparoscopy in penetrating abdominal trauma: a systematic review. World Journal of Surgery 2013; 37(1): 113-122

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Direct (primary) repair for penetrating colon injuries

A common treatment for wounds that penetrate the colon (part of the large intestine) is to attach the colon, from at or above the injury, to a bag outside the body via the abdominal wall (this is called a colostomy or fecal diversion). This diverts feces from the injury, to prevent infection and death. With improved critical care techniques and antibiotic therapy many trauma centers now manage their patients with direct repair of the colon to close the injury. The potential advantages are avoidance of complications of having an opening of the colon in the abdomen wall (stoma) to a bag, the need for another procedure for stoma closure, and the psychological and financial burden of stoma care.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Systematic review and meta-analysis of antibiotic prophylaxis to prevent infections from chest drains in blunt and penetrating thoracic injuries

This review concluded that infectious complications were less likely to develop when antibiotic prophylaxis was given to patients with penetrating thoracic injuries that required chest drains. The review was generally well conducted and the authors? conclusions appear to be reasonable, based on the evidence presented.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

What is the utility of the Focused Assessment with Sonography in Trauma (FAST) exam in penetrating torso trauma?

STUDY OBJECTIVE: A recent Cochrane Review has demonstrated that emergency ultrasonography decreases the amount of computerised tomographic scans in blunt abdominal trauma.13 However, there is no systematic review that has evaluated the utility of the Focused Assessment with Sonography for Trauma(FAST) exam in penetrating torso trauma. We systematically reviewed the medical literature for the utility of the FAST exam to detect free intraperitoneal blood after penetrating torso trauma.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

The initial trauma center fluid management of penetrating injury: a systematic review

BACKGROUND: Damage-control resuscitation is the prevailing trauma resuscitation technique that emphasizes early and aggressive transfusion with balanced ratios of red blood cells (RBCs), plasma (FFP), and platelets (Plt) while minimizing crystalloid resuscitation, which is a departure from Advanced Trauma Life Support (ATLS) guidelines. It is unclear whether the newer approach is superior to the approach recommended by ATLS.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Should prophylactic antibiotics be used in patients with penetrating abdominal trauma?

For over half a century antibiotics have been given to patients that have suffered from a penetrating injury to the abdominal peritoneal cavity in an attempt to decrease the incidence of post‐operative wound infection, intra‐abdominal infection and mortality. This review was designed to assess whether or not this practice is supported by medical evidence.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Skin Substitutes for Treating Chronic Wounds [Internet]

A wide variety of wound care products are available for clinicians to choose from when treating chronic wounds. Many of these products are said to mimic or substitute for some aspect of the skin's structure and function to promote healing and wound closure. The materials used to produce these products may be derived from human or animal tissue and may undergo extensive or minimal processing to make the finished product. The extent of processing and the source of the material used in the product also determines what regulatory pathway may be required before the product can be marketed. CMS requested this report on the types of wound care products that are commonly referred to as “skin substitutes” and on the regulatory pathways required for the different types of products. For this report, we have not created a definition for a skin substitute product. Instead we used the products listed under CMS codes Q4101 to Q4122 as a starting point and looked for similar products listed in the U.S. Food and Drug Administration (FDA) product codes to generate a list of products. We included only those products indicated for chronic wounds. We note that FDA does not refer to any product or class of products as “skin substitutes,” and we are not proposing an official classification system.

Technology Assessment Report - Agency for Healthcare Research and Quality (US).

Version: December 18, 2012
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Is behind armour blunt trauma a real threat to users of body armour? A systematic review

INTRODUCTION: Behind armour blunt trauma (BABT) has been defined as a non-penetrating injury caused by the rapid deformation of body armour. There has been an increasing awareness of BABT as an injury mechanism in both the military and civilian worlds; whether BABT results in serious injuries is debatable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

The efficacy of recombinant activated factor VII in severe trauma

The review found that there was no evidence that use of recombinant activated factor VII had a significant effect on mortality rates among patients with severe trauma and that more research was required. Although the review was limited by failure to provide relevant details of review processes, the authors? cautious conclusions appear well founded.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Does prehospital ultrasound improve treatment of the trauma patient? A systematic review

The review concluded that there was no evidence in the literature that prehospital ultrasound of the abdomen or thorax improved treatment of trauma patients. The review had a number of methodological and data limitations, but the authors? conclusions were suitably cautious and appeared appropriate.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Emergency thoracotomy: a review of its role in severe chest trauma

AIM: We aim to assess which group of patients with blunt or penetrating chest trauma will benefit from emergency thoracotomy (ET) and have a good functional outcome.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Preventing death from blood clots, the formation of blood clots and blood clots in the lungs in people who have had physical trauma

Thromboembolism (unwanted clotting of the blood) is a frequent complication in people who have experienced physical trauma and is also an important cause of death. The type of trauma, association with vascular injuries, and prolonged hospital bed rest are known risk factors for the development of deep vein thrombus (clot in veins of lower extremities) that can travel (embolize) to the lungs and cause death. Because of this it is usually recommended that people who have had major trauma are given mechanical or pharmacological treatments to prevent their blood forming unwanted blood clots. Mechanical interventions can include compression stockings, an air‐filled plastic tube that presses around the leg, a metal blood clot filter placed inside a vein; pharmaceutical drugs include unfractionated heparin, low weight molecular heparin, anticoagulants (e.g. warfarin), antiplatelet drugs (e.g. aspirin) and others. Sixteen studies involving 3,005 people are included in this review. We did not find strong evidence that either mechanical or pharmacological interventions reduce death or clots travelling to the lungs, but we found some evidence that they can prevent clots from forming in the legs.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Clinical effectiveness and cost-effectiveness of prehospital intravenous fluids in trauma patients

Trauma is an important cause of death and disability in the UK, with road traffic accidents causing a substantial number of injuries. There are no comprehensive audit data on the use of prehospital intravenous (IV) fluids available. Figures from previous research and some audit data suggest that between 5 and 18% of trauma patients receive fluids (generally crystalloids), representing 9-65 patients/year/100,000 population.

NIHR Health Technology Assessment programme: Executive Summaries - NIHR Evaluation, Trials and Studies Coordinating Centre (UK).

Version: 2004

Pharmacologic and Mechanical Prophylaxis of Venous Thromboembolism Among Special Populations [Internet]

Venous thromboembolism (VTE) is a prevalent and avoidable complication of hospitalization. Patients hospitalized with trauma, traumatic brain injury, burns, or liver disease; patients on antiplatelet therapy; obese or underweight patients; those having obesity surgery; or with acute or chronic renal failure have unequal risks for bleeding and thrombosis and may benefit differently from prophylactic therapy medication.

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: May 2013
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Venous Thromboembolism: Reducing the Risk of Venous Thromboembolism (Deep Vein Thrombosis and Pulmonary Embolism) in Patients Admitted to Hospital

Venous thromboembolism (VTE) is a term used to include the formation of a blood clot (a thrombus) in a vein which may dislodge from its site of origin to travel in the blood, a phenomenon called embolism. A thrombus most commonly occurs in the deep veins of the legs; this is called deep vein thrombosis. A dislodged thrombus that travels to the lungs is known as a pulmonary embolism.

NICE Clinical Guidelines - National Clinical Guideline Centre – Acute and Chronic Conditions (UK).

Version: 2010
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Negative Pressure Wound Therapy Devices [Internet]

The Center for Medicare Management at the Centers for Medicare and Medicaid Services (CMS) requested this report from The Technology Assessment Program (TAP) at the Agency for Healthcare Research and Quality (AHRQ). AHRQ assigned this report to the following Evidence-based Practice Center: ECRI Institute EPC (Contract Number: 290-2007-10063).

Technology Assessment Report - Agency for Healthcare Research and Quality (US).

Version: November 12, 2009
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Pain in Patients with Polytrauma: A Systematic Review [Internet]

Polytrauma is defined in the VHA Polytrauma Rehabilitation Centers Directive dated June 8, 2005 as: “injury to the brain in addition to other body parts or systems resulting in physical, cognitive, psychological, or psychosocial impairments and functional disability.” The definition of polytrauma has since expanded to include concurrent injury to two or more body parts or systems that results in cognitive, physical, psychological or other psychosocial impairments. Traumatic Brain Injury (TBI) often occurs in polytrauma and in combination with other disabling conditions including amputation, auditory or visual impairments, spinal cord injury (SCI), post-traumatic stress disorder (PTSD), and other mental health conditions.

Evidence-based Synthesis Program - Department of Veterans Affairs (US).

Version: September 2008
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Comparative Effectiveness of In-Hospital Use of Recombinant Factor VIIa for Off-Label Indications vs. Usual Care [Internet]

This report evaluates the level of evidence currently available to support the effectiveness and safety of using recombinant activated coagulation factor VII (rFVIIa) for clinical indications not approved by the U. S. Food and Drug Administration (FDA). rFVIIa is approved for a variety of uses in hemophilia patients who have developed antibody inhibitors that compromise the use of standard factor replacement. Use of this costly biologic product has expanded beyond these hemophilia-related indications to encompass a range of off-label uses, most of which are in-hospital uses. These uses differ substantially from the drug’s FDA approved label. The purpose of this report is two-fold: (1) To document the full range of clinical indications for which rFVIIa is being used and the types of studies available to evaluate these uses and (2) To provide a comparative effectiveness review of rFVIIa vs. usual care for several in-hospital clinical indications: intracranial hemorrhage, massive bleeding secondary to trauma, and the selected surgical procedures of cardiac surgery, liver transplantation, and prostatectomy.

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: May 2010
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Regular or selected use of computed tomography (CT) scanning to reduce deaths in people who have a high‐energy blunt‐traumatic injury

Trauma is the fifth leading cause of death in the world, and in people younger than 40 years of age, it is the leading cause of death. Since the 2000s, computed tomography (CT) has been increasingly used in the trauma bay. It is more sensitive and specific than conventional radiography and ultrasonography. By the 2010s, with technical and infrastructural improvements, CT has evolved into a reliable and important method of diagnostic imaging in trauma.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

When To Suspect Child Maltreatment

This guidance provides a summary of the clinical features associated with maltreatment (alerting features) that may be observed when a child presents to healthcare professionals. Its purpose is to raise awareness and help healthcare professionals who are not specialists in child protection to identify children who may be being maltreated. It does not give healthcare professionals recommendations on how to diagnose, confirm or disprove child maltreatment.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: July 2009
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Medical Encyclopedia

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    The cornea is the clear outer lens on the front of the eye. A corneal transplant is surgery to replace the cornea with tissue from a donor. It is one of the most common transplants done.
  • Head injury - first aid
    A head injury is any trauma to the scalp, skull, or brain. The injury may be only a minor bump on the skull or a serious brain injury.
  • Traumatic injury of the bladder and urethra
    Traumatic injury of the bladder and urethra involves damage caused by an outside force.
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Systematic Reviews in PubMed

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