Facial Fractures Have Similar Outcomes When Managed by Either Otolaryngology or Plastic Surgery: Encounters From a Single Level I Trauma Center.

Study Design: Retrospective cohort.

Objective: Traumatic facial fractures (FFs) often require specialty consultation with Plastic Surgery (PS) or Otolaryngology (ENT); however, referral patterns are often non-standardized and institution specific. Therefore, we sought to compare management patterns and outcomes between PS and ENT, hypothesizing no difference in operative rates, complications, or mortality.

Predictors of Anastomotic Leak After Esophagectomy for Cancer: Not All Leaks Increase Mortality.

Background: The impact of preoperative chemotherapy/radiation on esophageal anastomotic leaks (ALs) and the correlation between AL severity and mortality risk have not been fully elucidated. We hypothesized that lower severity ALs have a similar risk of mortality compared to those without ALs, and preoperative chemotherapy/radiation increases AL risk.

Methods: The 2016-2017 American College of Surgeons National Surgical Quality Improvement Program's procedure-targeted esophagectomy database was queried for patients undergoing any esophagectomy for cancer.

Decreased Length of Stay After Laparoscopic Diaphragm Repair for Isolated Diaphragm Injury After Penetrating Trauma.

Background: Isolated diaphragm injury (IDI) occurs in up to 30% of penetrating left thoracoabdominal injuries. Laparoscopic abdominal procedures have demonstrated improved outcome including decreased postoperative pain and length of stay (LOS) compared to open surgery. However, there is a paucity of data on this topic for penetrating IDI.

Early Tracheostomy for Severe Pediatric Traumatic Brain Injury is Associated with Reduced Intensive Care Unit Length of Stay and Total Ventilator Days.

Objectives: To determine whether, similar to adults, early tracheostomy in pediatric patients with severe traumatic brain injury (TBI) improves inhospital outcomes including ventilator days, intensive care unit (ICU) length of stay (LOS), and total hospital LOS when compared to late tracheostomy.

Design: Retrospective cohort analysis.

Setting: The Pediatric Trauma Quality Improvement Program (TQIP) database.

The current role of magnetic resonance imaging for diagnosing cervical spine injury in blunt trauma patients with negative computed tomography scan.

Clearance of cervical spine (CS) precautions in the neurologically altered blunt trauma patient can be difficult. Physical examination is not reliable, and although computed tomography (CT) may reveal no evidence of fracture, it is generally believed to be an inferior modality for assessing ligamentous and cord injuries. However, magnetic resonance imaging (MRI) is expensive and may be risky in critically ill patients.

Risk factors for traumatic injury findings on thoracic computed tomography among patients with blunt trauma having a normal chest radiograph.

Hypothesis: We sought to identify risk factors that might predict acute traumatic injury findings on thoracic computed tomography (TCT) among patients having a normal initial chest radiograph (CR).

Design: In this retrospective analysis, Abbreviated Injury Score cutoffs were chosen to correspond with obvious physical examination findings. Multivariate logistic regression analysis was performed to identify risk factors predicting acute traumatic injury findings.

A multidisciplinary organ donor council and performance improvement initiative can improve donation outcomes.

The shortage of organs available for transplantation has become a national crisis. The Department of Health and Human Services established performance benchmarks for timely notification, donation after cardiac death (DCD), and conversion rates (total donors/eligible deaths) to guide organ procurement organizations and donor hospitals in their attempts to increase the number of transplantable organs. In January 2007, an organ donor council (ODC) with an ongoing performance improvement case review process was created at a Level I trauma center.

Standard prophylactic enoxaparin dosing leads to inadequate anti-Xa levels and increased deep venous thrombosis rates in critically ill trauma and surgical patients.

Background: Deep venous thromboses (DVT) continue to cause significant morbidity in critically ill patients. Standard prophylaxis for high risk patients includes twice-daily dosing with 30 mg enoxaparin. Despite prophylaxis, DVT rates still exceed 10% to 15%.

Traffic law knowledge disparity between Hispanics and non-Hispanic whites in California.

Background: The Hispanic population is one group that is involved in a disproportionately high percentage of fatal motor vehicle collisions in the United States.

Study Objectives: This study investigated demographic factors contributing to a lack of knowledge and awareness of traffic laws among Hispanic drivers involved in motor vehicle collisions (MVCs) in southern California.

Methods: The cross-sectional study enrolled adults (n = 190) involved in MVCs presenting to a Level I trauma center in southern California over a 7-month period.

Elevated serum pancreatic enzyme levels after hemorrhagic shock predict organ failure and death.

Background: Intraluminal pancreatic enzymes have been shown in animal models to be associated with multiple organ failure after hemorrhagic shock, independent of pancreatitis. The translocation of these enzymes into the circulation may serve as a marker of hemorrhagic shock-induced gut ischemia in critically injured trauma patients. We hypothesized that serum amylase and lipase would be significantly elevated in patients presenting in hemorrhagic shock and in those who develop organ failure.

Sperm granuloma of the inguinal vas deferens mimicking recurrent incarcerated inguinal hernia.

Masses of the spermatic cord are rare and can be neoplastic or inflammatory lesions. We present a case of a sperm granuloma of the inguinal vas deferens presenting as a recurrent incarcerated inguinal hernia in a 42-year-old man.

Frameless stereotaxy to facilitate anterolateral thoracolumbar surgery: technique.

With the advent of frameless stereotaxy and its application to the spine, more precise and less invasive spinal procedures are possible. In addition to being less invasive, these techniques may increase surgeon confidence and allow shorter operating times. Described here is a case of Pott's disease of the thoracolumbar spine and how intraoperative image guidance can facilitate operative progress and accuracy in a patient in whom the underlying disease has severely deformed the normal anatomy of the spine.