Enteroatmospheric fistulas in open abdomen in trauma associated with abdominal reintervention and VAC therapy.

Background: Open abdomen is an alternative for the management of trauma patient, and negative pressure therapy of the wound using VAC device is a genuine sort of treatment. Although the device poses technical advantages, risks are present and a critical complication is the enteroatmospheric fistula formation (EAF).

Objective: To analize the role of negative pressure therapy length and VAC device number of changes on the EAF formation in trauma patients udergoing open abdomen.

Shotgun injuries. Need for a special point of view.

Background: Shotgun injuries (SGI) are infrequent, but due its special ballistics, are related to adverse outcomes.

Objective: To analyze operative and administrative variables, critical for the institution.

Method: Demographics and health-care related variables from SGI patients admitted to Military Central Hospital (Mexico City) between July 2006 and August 2019, were retrospectively studied.

Cadet Agustín Melgar and military peripheral vascular trauma approach during Chapultepec's Battle.

Trauma to peripheral vascular organ is a very frequent condition during military conflicts. Fortunately, comprehensive understanding of local and systemic pathophysiology, in addition to the development of innovative surgical techniques and technological advances, have improved the outcome regarding to survival and anatomic and functional conservation of the limbs. In this manuscript, we perform an historical and state of the art review related to the approach of the peripheral vascular trauma, on the basis of an heroical episode from the Mexico City's Campaign, during North American invasion 1846-1848: the defense of Chapultepec's Castle by cadet Agustin Melgar.

[Educación quirúrgica: el proceso multicanal de enseñanza-aprendizaje y la adquisición de competencias].

Background: Nowadays, there are few differences between civilian and military trauma, requiring to surgeons serving at urban hospitals, the acquisition of competences leading to implementation of management strategies for these cases. For their training, instructional designs related to surgical education, incorporating multimedia resources and favoring the multichannel teaching-learning process, have demonstrated remarkable benefits on competences acquisition by participants.

Method: Using an instructional design sustained on problems based learning and problems resolution, a digital video and its associated flat text were reviewed by the General Surgery residents, with the further application of a wide-answer problem-resolution questionnaire.

[Toracotomía en el departamento de urgencias en una paciente con actividad eléctrica sin pulso no traumática: potencial ampliación del horizonte terapéutico de una intervención de alta especialidad].

Instituida bajo recomendaciones objetivas, la toracotomía en el departamento de urgencias (TDU) se ha descrito como una maniobra quirúrgica salvatoria de la vida en pacientes traumatizados in extremis. Sin embargo, hay pocos reportes acerca de la experiencia con su empleo en la actividad eléctrica sin pulso no traumática. Describimos el caso de una paciente obstétrica exanguinada por sangrado masivo transoperatorio, en la que se realizó una TDU con un resultado óptimo para la vida y la función neurológica.

[Obstetric emergencies and non-emergencies at Central Military Hospital (I): Our vision and the epidemiologic horizon].

Background: Maternal morbidity and mortality pose a significant impact on national public health, being medical attention of obstetric emergencies (OE) and non-emergencies (ONE) of capital importance.

Methods: Descriptive and epidemiologic analysis of OE/ONE at a 3rd level military echelon.

Results: During a 34-months span, 48 patients were approached at the emergency department (1.