Background: Patients with coronavirus 2019 (COVID-19) are at high risk for respiratory dysfunction. The pulse oximetry/fraction of inspired oxygen (SpO/FiO) ratio is a non-invasive assessment of respiratory dysfunction substituted for the PaO:FiO ratio in Sequential Organ Failure Assessment scoring. We hypothesized that emergency department (ED) SpO/FiO ratios correlate with requirement for mechanical ventilation in COVID-19 patients.
View Article and Find Full Text PDFBackground: Blunt traumatic abdominal wall hernias (TAWHs) are rare but require a variety of operative techniques to repair including bone anchor fixation (BAF) when tissue tears off bony structures. This study aimed to provide a descriptive analysis of BAF technique for blunt TAWH repair. Bone anchor fixation and no BAF repairs were compared, hypothesizing increased hernia recurrence with BAF repair.
View Article and Find Full Text PDFBackground: This study aimed to determine the clinical impact of wound management technique on surgical site infection (SSI), hospital length of stay (LOS), and mortality in emergent colorectal surgery.
Methods: A prospective observational study (2021-2023) of urgent or emergent colorectal surgery patients at 15 institutions was conducted. Pediatric patients and traumatic colorectal injuries were excluded.
Background: Blunt traumatic abdominal wall hernias (TAWH) occur in <1 % of trauma patients. Optimal repair techniques, such as mesh reinforcement, have not been studied in detail. We hypothesize that mesh use will be associated with increased surgical site infections (SSI) and not improve hernia recurrence.
View Article and Find Full Text PDFIntroduction: Low molecular weight heparin (LMWH) is the standard for venous thromboembolic (VTE) chemo-prophylaxis in trauma patients; however, inconsistencies in the use of LMWH exist. The objective of this study was to assess VTE outcomes in response to a chemo-prophylaxis protocol guided by patient physiology (eg, creatinine clearance) and comorbidities.
Methods: ACS TQIP Benchmark Reports at a level 1 trauma center using a patient physiology and comorbidity directed VTE chemo-prophylaxis protocol were analyzed for Spring 2019 to Fall 2021.
Management of craniofacial injuries typically defaults to plastic, ophthalmology, and oral maxillofacial surgeons which can challenge these surgical subspecialists' capacity to care for both trauma victims and non-trauma patients. Evaluating the need to transfer patients to a higher level of trauma care for isolated craniofacial injuries warrants investigation. Our 5-year retrospective study measured the frequency of craniofacial injuries and subsequent surgical interventions in elderly trauma patients' ≥65 years old.
View Article and Find Full Text PDFBackground: In rural state trauma systems, management of the obstetrical trauma patient often defaults to transfer to level I trauma centers. We evaluate the necessity of transferring obstetrical trauma patients without severe maternal injury.
Materials And Methods: A retrospective 5-year review of obstetrical trauma patients admitted to a rural state-level I trauma center was conducted.
Background: Blunt traumatic abdominal wall hernias (TAWH) occur in approximately 15,000 patients per year. Limited data are available to guide the timing of surgical intervention or the feasibility of nonoperative management.
Methods: A retrospective study of patients presenting with blunt TAWH from January 2012 through December 2018 was conducted.
Background: Much has been written from the social science perspective surrounding surgeons' stress and burn out. The literature is sparse in reference to scientific investigations of the hemodynamic effect of that stress. This prospective clinical study quantifies the physiologic impact of performing surgery upon the acute care surgeon.
View Article and Find Full Text PDFBackground: School violence continues to afflict our educational institutions. In response, an institutional initiative was launched to train educators and school support staff in life-saving skills aimed at hemorrhage control.
Methods: The American College of Surgeons Committee on Trauma "Stop the Bleed" (STB) Program was promoted as a quality improvement initiative to schools within the geographic catchment area of this Level I Trauma Center.