Racial disparities in triage of adolescent patients after bullet injury.

Background: While pediatric trauma centers (PTCs) and adult trauma centers (ATCs) exhibit equivalent trauma mortality, the optimal care environment for traumatically injured adolescents remains controversial. Race has been shown to effect triage within emergency departments (EDs) with people of color receiving lower acuity triage scores. We hypothesized that African-American adolescents were more likely triaged to an ATC than a PTC compared with their White peers.

The impact of retained bullet fragments on outcomes in patients with gunshot wounds.

Background: Nationally, 115,000 non-fatal firearm injuries occurred in 2017, with many such victims possessing retained bullet fragments (RBFs); however, the impact of RBFs has not been well studied.

Methods: An institutional trauma database from an urban, level one trauma center was queried for patients presenting with gunshot wounds (GSWs) to the ED in 2017. GSWs were stratified by the presence or absence of RBFs.

COVER: A Curriculum in the Management of Soft Tissue Injury and Infection for Junior Surgery Residents.

Background: While wound management is a common task for practicing surgeons, there is a paucity of dedicated education on soft tissue management during residency training.

Objective: The COVER (Causes of soft tissue injury, Obstacles to closure, Vacuums and stitches, Epithelialization, Rationale for wound care) curriculum was developed to engage junior surgery residents in the management of soft tissue injury and infection.

Methods: Junior surgery residents participated in the COVER lab during academic years 2018-2020.

Difficult conversations: Navigating intimate partner violence with standardized patients.

Background: One in three women in the US experience intimate partner violence (IPV) in their lifetime. There are minimal opportunities for medical students to learn about responding to IPV.

Methods: Students participated in a learning intervention about recognizing and addressing IPV, followed by a standardized patient session.

A Multi-Modal Approach to Closing Exploratory Laparotomies Including High-Risk Wounds.

Background Laparotomy incisions with contamination have a high incidence of surgical site infection (SSI). One strategy to reduce SSI has been to allow these wounds to heal by secondary intention; however, this results in an ongoing need for wound care after discharge. Methods A prospectively maintained Acute and Critical Care Surgery database was queried for patients who underwent exploratory laparotomy during 2008-2018.

Hybrid Use of Negative Pressure Therapy in the Management of Partial Wound Closure After Girdlestone Procedure.

In a patient with septic arthritis and pressure ulcers requiring bilateral Girdlestone pseudoarthroplasty, hybrid open and closed incisional negative pressure therapy (ciNPT) is used to manage a closed surgical incision confluent with a large, open wound. Hybrid open and ciNPT facilitates both the healing of the primary closure as well as preparation of the wound bed for skin grafting. ciNPT can be used in partially closed wounds in combination with traditional NPT of the open portion of the wound to allow for more successful closure in wounds under tension.

Firearm laws and illegal firearm flow between US states.

Background: Considerable variation in firearm legislation exists. Prior studies show an association between stronger state laws and fewer firearm deaths. We hypothesized that firearms would flow from states with weaker laws to states with stronger laws based on proximity and population.

Stop the bleed: The impact of trauma first aid kits on post-training confidence among community members and medical professionals.

Introduction: Bystander training to control life-threatening hemorrhage is an important intervention to decrease preventable trauma deaths. We asked if receiving a trauma first aid (TFA) kit in addition to Bleeding Control (BC) 1.0 training improves self-reported confidence among community members (CM) and medical professionals (MP).

Combination of Girdlestone Pseudoarthroplasty and Negative Pressure Wound Therapy with Instillation and Dwell in the Treatment of Invasive Osteomyelitis of the Proximal Femur.

Osteomyelitis is a progressively destructive invasive infection of the bone that can result in both localized and systemic illness. This includes an acute suppurative infection, generalized weakness, a failure to thrive, a pathological fracture, and non-healing ulcers. When chronic osteomyelitis develops, therapeutic options are limited, as antimicrobial agents cannot penetrate the necrotic bone, and repeated surgical debridement may be needed.

Blunt splenic injury during colonoscopy: Is it as rare as we think?

Background: Post colonoscopy blunt splenic injury (PCBSI) is a rarely reported and poorly recognized event. We analyzed cases of PCBSI managed at our hospital and compared them to existing literature.

Methods: We identified 5 patients admitted with PCBSI through chart review.