Featured Article: London Trauma Conference 2009 Full Programme
This year's London Trauma Conference is being held on 9-11th December at the Royal Geographical Society in London. Building on previous years' successes the programme continues to challendge both speakers and audience with challenging talks on important subjects. This year's programme also includes a special one-day scientific symposium on "Translational Research in Trauma Haemostasis & Transfusion" as well as taught courses on "Core Topics in Trauma Care" and a Simulation Symposium.
Featured Case Study: Venous laceration to lower limb without fasciotomy
Trauma surgeons deal rarely with isolated penetrating venous injuries to the lower limbs due to the proximity of the vein-arterial complex. The limb remains vascularized but intensely swollen and a fasciotomy must be considered. Inserting a 'drip line' into both severed ends permits immediate venous return and improves the venous hypertension to the point where a fasciotomy can be avoided. This 'damage control' act does allow one to come back a day later and to reestablish continuity with any interposition graft available. The contralateral long saphenous is first choice, a synthetic graft second, a ligature and fasciotomy third choice.
Featured Images
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Right Atrial Injury
Injury to the right atrium
Juan C Duchesne MD, FACS, FCCP Spirit of Charity Hospital, New Orleans
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Sternotomy Post Stab Wound to the Heart
Stab wound to the heart
Juan C Duchesne MD, FACS, FCCP
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tension pneumothorax
Tension pneumothorax
Setthabutr Eaupanitcharoen, Department of surgery, Maharat Nakornrachasima hospital, Nakornrachasima Thailand
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Tension Pneumothorax
Servicio de Urgencias Hospital La Moraleja Madrid-Spain Dr. Santiago Doménech
Santiago Domenech MD Hospital La Moraleja. Madrid-Spain Emergency Dpt.
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Radiograph of a dental prosthesis found lodged in the trachea post trauma
Plain film radiograph showing a dental prosthesis located in the trachea
Jose Caballero Alvarado Walter Carpio Montenegro
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Simple pneumothorax closeup2
Simple pneumothorax - close-up
Dirk Soulliert
Recent Images
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Right Atrial Injury
Injury to the right atrium
Juan C Duchesne MD, FACS, FCCP Spirit of Charity Hospital, New Orleans
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Sternotomy Post Stab Wound to the Heart
Stab wound to the heart
Juan C Duchesne MD, FACS, FCCP
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Traumatic Splenic Abruption - Blunt Abdominal Trauma - RTA
Splenic abruption and rupture of the pancreatic tail
Dr. Nedal Matar - Dr. Ahmed Abanamy Hospital - Riyadh - Saudi Arabia
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Left Kidney Rupture - Blunt Abdominal Trauma - RTA
Left kidney rupture
Dr. Nedal Matar - Ahmed Abanamy Hospital - Riyadh - Saudi Arabia
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Small Bowel Mesenteric Tear - Blunt Trauma
A blunt mesenteric tear
Dr. Nedal Matar - Dr. Ahmed Abanamy Hospital - Riyadh - Saudi Arabia
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Omental Rupture - Blunt Abdominal Trauma - RTA
Traumatic rupture of the greater omentum
Dr. Nedal Matar - Dr. Ahmed Abanamy Hospital - Riyadh - Saudi Arabia
Article List
Case Presentations
Venous laceration to lower limb without fasciotomy
Shunting superficial femoral vein to avoid fasciotomy
, August 04, 2009
Trauma surgeons deal rarely with isolated penetrating venous injuries to the lower limbs due to the proximity of the vein-arterial complex. The limb remains vascularized but intensely swollen and a fasciotomy must be considered. Inserting a 'drip line' into both severed ends permits immediate venous return and improves the venous hypertension to the point where a fasciotomy can be avoided. This 'damage control' act does allow one to come back a day later and to reestablish continuity with any interposition graft available. The contralateral long saphenous is first choice, a synthetic graft second, a ligature and fasciotomy third choice.
Penetrating Cardiac Injuries
How to get the best possible outcome?
, January 10, 2009
82% survival in 35 consecutive stab heart patients was achieved in a South African metropolitan community hospital during the year 2008. Excellent and expediant prehospital management, skilled emergency room personnel and available surgical skill is necessary to achieve these results. The survival rate depends on the number of patients analyzed. The last 160 patients have a 70% survival rate, the last 35 patients have an 82% survival rate. Every surgical team can achieve good results under appropriate leadership.
C-spine fractures following falls in older patients
The importance of history taking and clinical suspicion
, October 05, 2008
This case highlights the importance of the history and high index of suspicion of c-spine fracture older patients following falls.
Impalement on the top of fence
, March 15, 2008
Thoracic trauma caused by a dart on the top of a fence.
Thoracic gunshot and retroaortic bullet
An example of why bullets should not be removed.
, July 27, 2007
Gunshot to Carotid Artery
Gunshot carotid artery: angiogram & vein graft repair
, July 10, 2007
A gunshot wound to the left neck, disrupting the internal and external carotid arteries. Operative repair with reversed vein graft.
Atypical use of the FAST1 manubrial intraosseous cannula.
Submitted by Farmery S, FRCA, Dip IMC and Balderston G, SR Para.
, June 15, 2007
We write describing our experience using the First Access for Shock and Trauma (FAST1) intra-osseous (I/O) cannula to perform a rapid sequence induction (RSI) at the roadside. The casualty was the victim of an RTC with difficult IV access and in urgent need of anaesthesia due to airway compromise and severe head injury. The I/O cannula was sited swiftly and without difficulty despite the patient being in the right decubitus position for postural airway drainage. Onset of anaesthesia/muscle relaxation showed no discernable delay compared with the intravenous route. Fluid flow and cannula security were also adequate.
Superficial Femoral Artery Impalement. Arterial Shunt
Demonstrating the utility of an arterial shunt prior to definitive repair.
, January 08, 2007
A combined femur fracture and superficial femoral artery impalement injury managed with temporary shunting to restore flow before fracture fixation and definitive repair.
Classic Case: Tension Haemothorax
A classic description of the tension haemothorax
, July 01, 2006
A classic description of tension haemothorax.
Classic Case: Tension Gastrothorax
, July 01, 2006
A rare case of tension gastrothorax following blunt trauma and diaphragmatic rupture.
Infrahepatic Inferior Vena Cava injury
Lateral repair
, October 16, 2005
Gunshot wound to the abdomen, with injury to the lateral wall of the infrahepatic inferior vena cava. The IVC was accessed through a right medial visceral rotation and a lateral repair performed.
