Pancreaticoduodenectomy in trauma patients with grade IV-V duodenal or pancreatic injuries: a post hoc analysis of an EAST multicenter trial.

Introduction: The utility of pancreaticoduodenectomy (PD) for high-grade traumatic injuries remains unclear and data surrounding its use are limited. We hypothesized that PD does not result in improved outcomes when compared with non-PD surgical management of grade IV-V pancreaticoduodenal injuries.

Methods: This is a retrospective, multicenter analysis from 35 level 1 trauma centers from January 2010 to December 2020.

Outcomes among trauma patients with duodenal leak following primary versus complex repair of duodenal injuries: An Eastern Association for the Surgery of Trauma multicenter trial.

Background: Duodenal leak is a feared complication of repair, and innovative complex repairs with adjunctive measures (CRAM) were developed to decrease both leak occurrence and severity when leaks occur. Data on the association of CRAM and duodenal leak are sparse, and its impact on duodenal leak outcomes is nonexistent. We hypothesized that primary repair alone (PRA) would be associated with decreased duodenal leak rates; however, CRAM would be associated with improved recovery and outcomes when leaks do occur.

Analysis of Need for Intervention in Low-Grade Traumatic Splenic Injury.

Background: Blunt splenic injuries are common traumatic injuries. Severe injuries may require blood transfusion, procedural, or operative intervention. Conversely, patients with low-grade injuries and normal vital signs frequently do not require intervention.

Multiyear experience with mobile online platform for documentation of acute care surgery fellows supervision.

Background: There is currently no standard for documenting supervision of acute care surgery (ACS) fellows. To accomplish this goal, we developed a web-based survey that is accessible via mobile platform. We hypothesize that our mobile access survey is an effective, reproducible tool for assessing fellow clinical performance.

causing necrotising soft tissue infection in an immunocompetent adult.

A 72-year-old woman presented with concern for a necrotising soft tissue infection (NSTI) 6 days after a tree branch impaled her left lower extremity while hiking in Hawaii. The wound was irrigated and closed at a local clinic in Hawaii. She completed a 5-day course of clindamycin.

Urology Individual Critical Task List: Creation and Validation of a Simulation Curriculum.

Introduction: Individual critical task lists (ICTLs) are skills identified by the U.S. Army for the maintenance of combat readiness in each military occupational specialty, including physicians.

Rare Use of Posterolateral Thoracotomy in an Austere Environment.

A 25-year-old local national male presented to a split Forward Surgical Team after impalement of the posterior chest with a metal fragment. The patient was hemodynamically normal, but no imaging was available to determine the depth of penetration or the size of the internal portion of the fragment. This case represents a rare indication for posterolateral thoracotomy in an austere trauma setting.

A Novel Use of the Erector Spinae Block in the Austere Environment.

A 25 year-old male presented with penetrating chest trauma to a split forward surgical team located in an austere setting. Due to limited resources and a minimal monitoring in-transit a regional anesthetic was placed for pain control. This is the first description of an Erector Spinae Block utilized in a far forward combat setting.