Search

Vascular trauma arises from a variety of causes: penetrating and blast injury in conflict zones, and recently terrorist attacks on civilians; blunt injury from road traffic accidents and falls from height; and iatrogenic injury from modern invasive medicine. Massive haemorrhage is the pre-eminent cause of preventable death. Trauma teams now understand the necessity to control bleeding rapidly with targeted damage-control surgery, and goal-directed resuscitation, before the lethal triad of shock, hypothermia and coagulopathy make attempted salvage futile. Vascular trauma in the extremities may be identified clinically with hard signs of injury alone. Trauma CT scanning rapidly identifies sites of bleeding in chest, abdomen or pelvis. Vascular surgeons are key members of the trauma team, offering control of bleeding and vascular reconstruction, using aspects of open surgical and endovascular techniques. Once haemodynamic stability has been established, definitive surgical care can restore function and allow successful rehabilitation. [ABSTRACT FROM AUTHOR]

Vascular trauma arises from a variety of causes: penetrating and blast injury in conflict zones, and recently terrorist attacks on civilians; blunt injury from road traffic accidents and falls from height; and iatrogenic injury from modern invasive medicine. Massive haemorrhage is the pre-eminent cause of preventable death. Trauma teams now understand the necessity to control bleeding rapidly with targeted damage-control surgery, and goal-directed resuscitation, before the lethal triad of shock, hypothermia and coagulopathy make attempted salvage futile. Vascular trauma in the extremities may be identified clinically with hard signs of injury alone. Trauma CT scanning rapidly identifies sites of bleeding in chest, abdominal or pelvis. Vascular surgeons are key members of the trauma team, offering control of bleeding and vascular reconstruction, using aspects of open surgical and endovascular techniques. Once haemodynamic stability has been established, definitive surgical care can restore function and allow successful rehabilitation. [ABSTRACT FROM AUTHOR]

Vascular trauma arises from a variety of causes: penetrating and blast injury in conflict zones; blunt injury from road traffic accidents and falls; and iatrogenic injury from modern invasive medicine. Massive haemorrhage is the pre-eminent cause of preventable death and trauma teams now understand the necessity to control bleeding rapidly, so that effective resuscitation can begin. Vascular surgeons are key members of the trauma team, offering control of bleeding and vascular reconstruction, using aspects of open surgical and endovascular techniques. Unstable trauma patients with haemorrhagic shock require targeted damage-control surgery and goal-directed resuscitation, before the lethal triad of shock, hypothermia and coagulopathy make attempted salvage futile. Once stability has been established, definitive surgical care can restore function and allow successful rehabilitation. [ABSTRACT FROM AUTHOR]

Vascular trauma arises from a variety of causes: penetrating and blast injury in conflict zones; blunt injury from road traffic accidents and falls; and iatrogenic injury from modern invasive medicine. Massive haemorrhage is the pre-eminent cause of preventable death and trauma teams now understand the necessity to control bleeding rapidly, so that effective resuscitation can begin. Vascular Surgeons are key members of the trauma team offering control of bleeding and vascular reconstruction, using aspects of open surgical and endovascular techniques. Unstable trauma patients with haemorrhagic shock require targeted damage-control surgery and goal-directed resuscitation, before the lethal triad of shock, hypothermia, and coagulopathy make attempted salvage futile. Once stability has been established, definitive surgical care can restore function and allow successful rehabilitation. [ABSTRACT FROM AUTHOR]

Abstract: The restructuring of emergency healthcare services has led to more blunt thoracic trauma being treated by a multidisciplinary team, including general, orthopaedic and trauma surgeons, often without immediate access to a thoracic surgeon. Having a critical mass of injured patients in a central location, it has been possible to bring expertise from other areas of intensive care, radiology and surgery and apply new technology and techniques to the trauma patient. We now see the regular use of endovascular stenting and embolization reducing the need for urgent surgery on unstable patients and the increasing use of extracorporeal membranous oxygenation (ECMO) to salvage patients with acute respiratory distress syndrome. A more liberal use of video-assisted thoracic surgery (thoracoscopic) decortication and chest wall fixation both reduce ICU requirements and shorten hospital stay. It is hoped that these improvements in the hospital management of chest injuries will not only improve survival, but that the reduction in the late sequelae of chronic pain and loss of stamina will translate into improved return-to-work rates. [Copyright &y& Elsevier]

Abstract: The commonest cause of death in children in developed countries is trauma, accounting for over 350 deaths/year in the UK. In children, about 75% of trauma occurs on the roads and the majority of these involve blunt trauma with most children sustaining multiple injuries. It is more common in boys (about two- to threefold) and in the summer. The age distribution is bimodal with peaks affecting toddlers and teenagers. Mortality and morbidity have been reduced by preventative strategies, for example traffic calming systems, road safety programmes, seat belts, better car design and bicycle helmets. Once injured, swift management by skilled staff in a trauma network gives the best results and key to this are care in transport, and recognition and management of the injuries and finally rehabilitation. Important strategies for major trauma include what has become known as ‘damage limitation surgery’. In children, the absence of a plausible mechanism of injury should raise the suspicion of child abuse, and a plausible mechanism but an unusual situation might suggest neglect (e.g. a skate board injury in an 8-year-old at 23:00 hours). [Copyright &y& Elsevier]

Abstract: The incidence and type of vascular injury differs in different geographical locations. Blunt and iatrogenic injuries are the two commonest causes of vascular trauma in most European countries including the UK. However, in the USA, most vascular injuries are the result of stab or gunshot wounds. Vascular injuries are associated with high morbidity and mortality. They require a clear concept of the management and timely intervention in order to avoid early and late complications. This article outlines the basic principles in the management of vascular trauma. [Copyright &y& Elsevier]

Abstract: The majority of blunt thoracic injuries occur in the setting of multiple trauma and are often missed or underestimated. Most can be managed non-operatively, heal well and are not the major cause of long-term physical disability. The fact that surgical intervention is not usually necessary does not mean it is never required. We aim to describe the non-operative early interventions, with appropriate use of chest drains, oxygenation, pain relief and management of pulmonary secretions, that are the basis of successful treatment. We also describe the situations where the recovering patient will benefit from the opinion of a thoracic surgeon. [Copyright &y& Elsevier]

Abstract: This contribution discusses basic concepts of vascular trauma. [Copyright &y& Elsevier]

Abstract: This contribution discusses the basic concepts of vascular trauma. [Copyright &y& Elsevier]