Fixed-Distance Model for Balloon Placement During Fluoroscopy-Free Resuscitative Endovascular Balloon Occlusion of the Aorta in a Civilian Population.

Importance: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an innovative procedure in the treatment of noncompressible truncal hemorrhage. However, readily available fluoroscopy remains a limiting factor in its widespread implementation. Several methods have been proposed to perform REBOA without fluoroscopic guidance, and these methods were adapted predominantly from the military theater.

Abbreviated laparotomy or damage control laparotomy: Why, when and how to do it?

The goal of abbreviated laparotomy is to treat severely injured patients whose condition requires an immediate surgical operation but for whom a prolonged procedure would worsen physiological impairment and metabolic failure. Indeed, in severely injured patients, blood loss and tissue injuries enhance the onset of the "bloody vicious circle", triggered by the triad of acidosis-hypothermia-coagulopathy. Abbreviated laparotomy is a surgical strategy that forgoes the completeness of operation in favor of a physiological approach, the overriding preference going to rapidity and limiting the procedure to control the injuries.

Kendrick's extrication device and unstable pelvic fractures: Should a trochanteric belt be added? A cadaveric study.

Introduction: Pre-hospital pelvic stabilisation is advised to prevent exsanguination in patients with unstable pelvic fractures (UPFs). Kendrick's extrication device (KED) is commonly used to extricate patients from cars or crevasses. However the KED has not been tested for potential adverse effects in patients with pelvic fractures.

Feasibility of Catheter Placement Under Ultrasound Guidance for Progressive Preoperative Pneumoperitoneum for Large Incisional Hernia with Loss of Domain.

Introduction: Large incisional hernias with loss of domain (LIHLD) of the abdominal wall remain a therapeutic challenge due to the difficulty of replacing the contents of the hernia sac into the peritoneal cavity. Preoperative progressive pneumoperitoneum (PPP) is a valuable option. The purpose of this study was to evaluate the feasibility of peritoneal catheter insertion under ultrasound guidance for PPP and to compare the morbidity and mortality of this new technique to previously used techniques in our department.

Clamshell incision versus left anterolateral thoracotomy. Which one is faster when performing a resuscitative thoracotomy? The tortoise and the hare revisited.

Background: The clamshell incision (CI) offers a better exposure than the left anterolateral thoracotomy (LAT) as a resuscitative thoracotomy. Most surgeons will have to manage a heart wound only once or twice in their career. The patient's survival depends on how fast the surgeon can control the heart wound; however, it is unclear which of the two incisions allows for faster control in the hands of inexperienced surgeons.

Bilateral anterior thoracotomy (clamshell incision) is the ideal emergency thoracotomy incision: an anatomic study.

Background: Emergency thoracotomy (ET) is a procedure that provides rapid access to intrathoracic structures for thoracic trauma patients arriving at the hospital in extremis. This study assesses the accessibility of intrathoracic structures provided by six different ET incisions. We hypothesize that the bilateral anterior thoracotomy ("clamshell" incision) provides the most rapid and definitive accessibility to intrathoracic structures.

[Original vacuum dressing for the treatment of open femur fracture with gangrene immobilized by external fixation].

We report a case of gangrene, which developed following an open fracture of the femur immobilized with an external fixator in a 45-year-old patient. A conventional vacuum dressing (VAC Therapy) could not be applied with the external fixator in place. An original vacuum dressing was thus fashioned after surgical debridement.

First clinical study of a new virus-inhibiting surgical glove.

Question Under Study: Prospective clinical study to evaluate the tolerance, ergonomics and glove barrier value (mechanical resistance to breach) of a new surgical glove sandwiching droplets of a disinfecting agent between two layers of a synthetic elastomer (G-VIR) able to inactivate viruses when breached.

Methods: 100 surgical procedures were performed by six surgeons wearing G-VIR on 100 patients included after informed consent. Procedures were classified into laparoscopic (n = 28) or open surgery (n = 72); open surgery being subdivided either into superficial (n = 33) and deep (n = 39) or into hernia (n = 32) and non hernia (n = 40).

[Translational research and Cancer Plan].

The French Cancer Plan 2003-2007 has made translational research central to its research programme, to ensure the care-research continuum and the quickest application possible for the most recent discoveries, for the patients' benefit. This is a new field of research, still little-known or ill-understood. A working group, composed of physicians and researchers from academic research and industrial research, sought to define translational research in cancerology and define the issues at stake in it.

[Management of corpus cavernosum trauma].

Rupture of the tunica albuginea of the corpus cavernosum of the penis is a rare disease, usually occurring in young adults during sexual intercourse. In Western countries, the most frequent causes is coital injuries. Ultrasound, cavernography or magnetic resonance imaging of the penis can be performed to determine the exact site of the fracture.

The epidemiology of trauma of the genitourinary system after traffic accidents: analysis of a register of over 43,000 victims.

Objective: To analyse the frequency and type of injury to the genitourinary system, by user category, after traffic accidents.

Patients And Methods: The register which forms the basis of this study is unique in Europe and includes 43,056 victims of road traffic accidents, and was compiled between 1996 and 2001. The categories of road users included: motorists, motorcyclists, cyclists, pedestrians, van and bus users, and roller skaters.

Anticipated detection of imminent surgeon-patient barrier breaches. A prospective randomized controlled trial using an indicator underglove system.

The double gloving indicator underglove system (IUS) is based on a colored detection of the outer glove perforation. Our objective was to determine the IUS efficiency to detect outer glove perforations and to reduce the risks of blood and body fluids exposure, warning the surgeon before the breach of the surgeon-patient barrier (SPB). A series of 100 visceral surgical procedures were randomly assigned to either double (IUS) or single gloving.

[Surgical glove use in France].

Since the end of the 19th century, surgeons have used gloves to prevent infectious complications to the patient. The AIDS epidemic of the 1980's sparked the use of universal precautions to protect the surgeon from infection and vice-versa. The interface between surgeon and patient is in effect a two-way street.

[Types and mechanisms of 54 cases of kidney trauma in car drivers injured by road accident].

Purpose: To analyse the types, mechanisms and severity of kidney trauma in injured car drivers and the effects of the presence or absence of the safety belt on the renal lesions observed.

Material And Methods: 64,325 road accident victims were reported between 1996 and 2002. Data collection was performed in 96 primary care departments, 160 inpatient departments and 11 convalescence centres.

[Laparoscopic Janeway gastrostomy: an advantageous solution for self-sufficient enteral feeding].

Introduction: Laparoscopic gastrostomy according to Janeway (LGJ) is an alternative to percutaneous gastrostomy techniques.

Methods: A series of 10 LGJ is reported. The laparoscopic technique involves an isoperistaltic tube of 6-7 cm of length and 10-12 mm of diameter is created by 2 applications of linear stapling and cutting device.

[Liver abscesses secondary to sigmoid diverticulitis: report of four cases].

Introduction: Pyogenic liver abscess often revealed by right sided abdominal pain and fever is a serious and life-threatening pathology. Biliary tract disease is the origin of the abscess in most cases but sometimes remains unidentified. A sigmoid septic source sometimes paucisymptomatic or hidden by an immunosuppressive treatment must be looked for.

[A case of late pancreatic metastasis from renal cell carcinoma].

The authors report the case of a 58-year-old man who developed four pancreatic metastases ten years after radical nephrectomy for pT3NO renal cell carcinoma. Total pancreatectomy was performed and, three years later, the patient was in good general health, free from any tumour recurrence. Pancreatic metastases from renal cell carcinoma are rare and generally occur late.

Ballistic study of the SAPL GC27 gun: is it really "nonlethal"?

To evaluate the potential dangers of the "nonlethal" 12-gauge single-shot handgun SAPL GC27 with Fun-Tir (FT) and mini-Gomm-Cogne (mGC) ammunition, a ballistic study was performed with both types of ammunition. Nine unembalmed human corpses covered with a cloth sheet were shot through the right and left pectoral regions. With the mGC ammunition, rib fractures were observed when the firing range was less than 2 meters, skin perforation when the range was less than 1.