Shiraz University of Medical Sciences
Bulletin of Emergency And Trauma
2322-2522
2322-3960
4
Issue 1
2016
01
01
Management of Deep Vein Thrombosis (DVT) Prophylaxis in Trauma Patients
1
7
EN
Shahram
Paydar
0000-0002-6980-2576
Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
paydarsh@gmail.com
Golnar
Sabetian
Department of Intensive Care Medicine, Trauma Research Center, Shahid Rajaee (Emtiaz) Hospital, Shiraz University of Medical
Sciences, Shiraz, Iran
Hosseinali
Khalili
Neuroscience Research Center, Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran
Javad
Fallahi
Department of Internal Medicine, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
Mohammad
Tahami
Department of Orthopedics Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
Bizhan
Ziaian
Department of Thoracic Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
ziaianb@sums.ac.ir
Hamid Reza
Abbasi
0000-0002-2016-9060
Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
abbasimezy@yahoo.com
Shahram
Bolandparvaz
0000-0002-8875-5998
Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
bolandpa@yahoo.com
Fariborz
Ghaffarpasand
0000-0002-1721-9987
Neuroscience Research Center, Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran
fariborz.ghaffarpasand@gmail.com
Zahra
Ghahramani
0000-0002-7394-952X
Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
zghahreman@sums.ac.ir
Deep vein thrombosis (DVT) and pulmonary embolism (PTE) are known as venous thromboembolism (VTE). DVT occurs when a thrombus (a blood clot) forms in deep veins of the body, usually in the lower extremities. It can cause swelling or leg pain, but sometimes may occur with no symptoms. Awareness of DVT is the best way to prevent the VTE. Patients with trauma are at increased risk of DVT and subsequent PE because of coagulopathy in patients with multiple trauma, DVT prophylaxis is essential but the VTE prophylaxis strategy is controversial for the trauma patients. The risk factors for VTE includes pelvic and lower extremity fractures, and head injury.
Management,Deep Vein Thrombosis,DVT,prophylaxis,Trauma,Patients
https://beat.sums.ac.ir/article_44304.html
https://beat.sums.ac.ir/article_44304_980a406b8c48fe278cf201b07865f3de.pdf
Shiraz University of Medical Sciences
Bulletin of Emergency And Trauma
2322-2522
2322-3960
4
Issue 1
2016
01
01
Severe Cranioencephalic Trauma: Prehospital Care, Surgical Management and Multimodal Monitoring
8
23
EN
Luis
Rafael
Moscote-Salazar
Universidad de Cartagena
mineurocirujano@aol.com
Andres
M.
Rubiano
Hernando
Raphael
Alvis-Miranda
Willem
Calderon-Miranda
Gabriel
Alcala-Cerra
Marco
Antonio
Blancas Rivera
Amit
Agrawal
dramit_in@yahoo.com
Traumatic brain injury is a leading cause of death in developed countries. It is estimated that only in the United States about 100,000 people die annually in parallel among the survivors there is a significant number of people with disabilities with significant costs for the health system. It has been determined that after moderate and severe traumatic injury, brain parenchyma is affected by more than 55% of cases. Head trauma management is critical is the emergency services worldwide. We present a review of the literature regarding the prehospital care, surgical management and intensive care monitoring of the patients with severe cranioecephalic trauma.
Neurotrauma,Traumatic brain injury,emergency,Trauma,Management
https://beat.sums.ac.ir/article_44314.html
https://beat.sums.ac.ir/article_44314_75a6ef0542c397fd50f501a9990f8d73.pdf
Shiraz University of Medical Sciences
Bulletin of Emergency And Trauma
2322-2522
2322-3960
4
Issue 1
2016
01
01
Cranioplasty Results after Application of Anti-adhesive Films (OrthoWrap™) in Traumatic Decompressive Craniectomy
24
28
EN
Hosseinali
Khalili
0000-0002-3390-4212
Shiraz University of Medical Sciences
khalilih16@gmail.com
Aydin
Omidvar
Neurosurgery Department, Shiraz University of Medical Sciences
aydineomidvar84@yahoo.com
Fariborz
Ghaffarpasand
0000-0002-1721-9987
Shiraz University of Medical Sciences
fariborz.ghaffarpasand@gmail.com
Golnaz
Yadollahikhales
Shiraz University of Medical Sciences
yadolahig@gmail.com
Objective: To determine the effects of application of anti-adhesive films (OrthoWrap™) in traumatic decompressive craniectomy on prevention of adhesion formation and facilitation of subsequent cranioplasty.Methods: This was a retrospective cohort study being performed in Shahid Rajaei hospital (Shiraz Level I trauma center) during a 12-month period (from March 2012 to April 2013) including 93 patients undergoing traumatic decompressive craniectomy. Patients who received OrthoWrap™ during the initial craniectomy (n=44) were compared to those who did not (n=49). Two study groups were matched regarding the baseline characteristics. The perioperative indices including the surgical time, amount of bleeding, transfusion and 6-month Glasgow Outcome Scale (GOS) were compared between two study groups.Results: There was no significant difference between two study groups regarding the baseline characteristics. We found that the cranioplasty duration (113.3±33.2 vs. 146.9±34.9 minutes; p<0.001) and amount of intraoperative bleeding (182.1±98.3 vs. 270.6±77.6 mL; p=0.043) was significantly lower in those who had OrthoWrap™ compared to control group. The final GCS (p=0.052) as well as GOSE (p=0.653) was comparable between groups. The infection rate was comparable between two study groups (p=0.263).Conclusion: Application of OrthoWrap™ during decompressive craniectomy in those with severe traumatic brain injury is associated with shorter duration of operation and less intraoperative bleeding in subsequent cranioplasty. Infection rate and neurologic outcome was comparable between study groups.
Decompressive craniectomy,Anti-adhesive Films (OrthoWrap™),Craniplasty
https://beat.sums.ac.ir/article_44305.html
https://beat.sums.ac.ir/article_44305_412b92f1bce3c36dbd714cdd5e0e5cdf.pdf
Shiraz University of Medical Sciences
Bulletin of Emergency And Trauma
2322-2522
2322-3960
4
Issue 1
2016
01
01
Effect of Platelet Rich Plasma Combined with Chitosan Biodegradable Film on Full-Thickness Wound Healing in Rat Model
29
37
EN
Rahim
Mohammadi
0000-0002-2104-9829
Department of Internal Medicine and Clinical Pathology, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran.
r.mohammadi@urmia.ac.ir
Moein
Mehrtash
Department of Surgery and Diagnostic Imaging, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
Moeid
Mehrtash
Department of Surgery and Diagnostic Imaging, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
Nava
Hassani
Department of Surgery and Diagnostic Imaging, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
Ali
Hassanpour
Department of Mechanical Engineering of Biosystems, Faculty of Agriculture, Urmia University, Urmia, Iran
Objective: To assess the effects of platelet rich plasma (PRP) with chitosan biodegradable film on full thickness wound healing in rat.Methods: This was an experimental study being performed in 2015 during a 4-month period. Twenty-four male white Wistar rats were divided into four groups of 12 rats each, randomly: Control group (SHAM) with creation of wounds and no treatment, PRP group with creation of wounds and application of one milliliter PRP, Chitosan group (CHIT) with dressing the wound with chitosan and CHIT/PRP group with application of one mL PRP and dressing the wound with chitosan. The wounds were created by cutting healthy skin. Wound size was measured on 6, 9, 12, 15, 18 and 21 post surgery and was compared between groups.Results: Reduction in wound area, hydroxyproline contents and biomechanical parameters indicated there was significant difference (p=0.001) between group CHIT/PRP and other groups. Biomechanical testing was performed on day 9 post surgery in incisional model. Quantitative histological studies and mean rank of the qualitative studies demonstrated that there was significant difference (p<0.001) between group CHIT/PRP and other groups.Conclusion: PRP with chitosan have beneficial effects on wounds repair and could be suggested for treating various types of wounds in animals and human being.
Chitosan,Platelet rich plasma (PRP),Wound healing,Full-thickness wound
https://beat.sums.ac.ir/article_44306.html
https://beat.sums.ac.ir/article_44306_9e11ef03752354a52d1003757a2d20e5.pdf
Shiraz University of Medical Sciences
Bulletin of Emergency And Trauma
2322-2522
2322-3960
4
Issue 1
2016
01
01
Incidence of Deep Vein Thrombosis in Patients Undergoing Degenerative Spine Surgery on Prophylactic Dalteparin; A Single Center Report
38
42
EN
Alireza
Farid Moayer
Navideh
Mohebali
navideh002@yahoo.com
Ali
Razmkon
ali.razmkon@gmail.com
Objective: To determine the incidence of deep vein thrombosis (DVT) in patients undergoing spinal surgeries receiving prophylactic doses of Deltaparin in a single center in central Iran.Method: This cross-sectional study was conducted in Shariatee hospital of Isfahan during a 12-month period. We included all the patients undergoing elective spinal surgeries in our center during the study period who received prophylactic dosages of subcutaneous Dalteparin (5000 unit daily) the first postoperative day. Those with absolute contraindications of anticoagulation therapy were not included in the study. Patients were followed for 3 months clinically and the incidence of DVT was recorded. DVT was suspected clinically and was confirmed by color Doppler sonography.Results: Overall we included 120 patients with mean age of 44.8 ± 12.6 years among whom there were 54 (45%) men and 66 (55%) women. Lumbar discectomy (32.9%) and laminectomy (20.2%) were the most common performed procedures. DVT was detected in 1 (0.83%) patient in postoperative period. None of the patients developed pulmonary embolism and none hemorrhagic adverse event was recorded. The patient was treated with therapeutic unfractionated heparin and was discharged with warfarin. Conclusion: Our results shows the efficacy of LMWH (Dalteparin) in reducing the incidence of DVT to 0.83%. These results also show the safety of Dalteparin in spine surgery because of lack of bleeding complication.
Deep Vein Thrombosis,Spinal surgery,Dalteparin,Low molecular weight heparin (LMWH),Pulmonary thromboembolism (PTE)
https://beat.sums.ac.ir/article_44307.html
https://beat.sums.ac.ir/article_44307_4882586dc443c0877b8fa9530e0ff838.pdf
Shiraz University of Medical Sciences
Bulletin of Emergency And Trauma
2322-2522
2322-3960
4
Issue 1
2016
01
01
Economic Burden of Road Traffic Accidents; Report from a Single Center from South Eastern Iran
43
47
EN
Aliyeh
Sargazi
Medical Student, Zabol University of Medical Sciences, Zabol, Iran.
sargazi.al@gmail.com
Atefeh
Sargazi
Civil Engineering Student, Sistan and Baloochestan University, Zahedan, Iran.
Prigil Kumar
Nadakkavukaran Jim
IT Engineer, Linlithgow, UK.
HoseinAli
Danesh
Assistant Professor, Zahedan University of Medical Sciences, Zahedan, Iran.
Forough
Sargolzaee Aval
Zohre
Kiani
Medical Student, Kerman University of Medical Sciences, Kerman, Iran.
AmirHosein
Lashkarinia
Medical Student, Zahedan University of Medical Sciences, Zahedan, Iran.
Zahra
Sepehri
Assistant Professor, Zabol University of Medical Sciences, Zabol, Iran.
sepehri_za@yahoo.com
Objective: To determine the economic burden of road traffic accidents (RTAs) in patients admitted to a single center in south eastern Iran.Methods: This cross-sectional study was conducted in Amir-Al-Momenin hospital of Zabol affiliated with Zabol University of Medical Sciences during a 12-month period from April 2012 to April 2013. All the RTAs patients who were admitted to our emergency department were included. The direct expenses of hospital care were recorded according to their medical charts and the accountant registration information. Data are presented according to different RTAs characteristics.Results: Overall 1155 patients were included in the current study with mean age of 36.7 ± 5.14 years among whom there were 673 (58.3%) men and 482 (41.7%) women. The annual incidence of RTAs were calculated to be 288 per 100,000 population. The RTAs economic burden in our center was 589,448.49 USD which accounted for 10.4% of total hospital expenses during the study period. The money spend on RTAs in our center was 130 times more than gross national income per capita. Cost of each patient in road traffic was 15 times more than cost of an average patient of the hospital in other sections.Conclusion: With considerable high ratio of accidents in Zabol, proper intervention is needed for controlling and preventing RTAs in order to decrease its injuries, impact and the associated economic burden.
Road traffic accidents (RTAs),Economic burden,Healthcare Expenses,Iran
https://beat.sums.ac.ir/article_44308.html
https://beat.sums.ac.ir/article_44308_edf9b1eae3f5e7068d9f13832dc63b03.pdf
Shiraz University of Medical Sciences
Bulletin of Emergency And Trauma
2322-2522
2322-3960
4
Issue 1
2016
01
01
Advanced Trauma Life Support (ATLS) in Hungary; The First 10 Years
48
50
EN
Endre
Varga
endrevargamd@yahoo.com
Endre
Csonka
Balázs
Kószó
Zoltán
Pető
Zsuzsanna
Ágoston
Erika
Gyura
Gábor
Nardai
Kristóf
Boa
Gábor
Süveges
Advanced Trauma Life Support (ATLS) programs are recognized as the standard educational trauma program worldwide. Data suggest that ATLS has a positive impact on the value of trauma care. The ATLS Hungary program has been started in 2005, celebrating its 10-year anniversary this year. In the present brief communication a brief overview is provided on the program.Student evaluation and statistical data about the participants were collected throughout the 10-year history of the Hungarian program.Student evaluation shows a high level of satisfaction amongst the participating doctors. Most participants are working in higher level centers. The Hungarian program shows good quality according to the participants. Establishing at least one new center is crucial to be able to provide the course for every professional interested in it or required to take it.
Advanced Trauma Life Support,ATLS,Trauma,Training,Hungary
https://beat.sums.ac.ir/article_44309.html
https://beat.sums.ac.ir/article_44309_a3d2eeac971455bd3bba88b93c2f2b9f.pdf
Shiraz University of Medical Sciences
Bulletin of Emergency And Trauma
2322-2522
2322-3960
4
Issue 1
2016
01
01
Small Bowel Obstruction Secondary to Femoral Hernia; Case Report and Review of the Literature
51
53
EN
Majid
Akrami
Mohamamd Yasin
Karami
Vahid
Zangouri
zangouri.vahid1390@gmail.com
Iman
Deilami
Mehrnoush
Maalhagh
Femoral hernias account for 2% to 4% of groin hernias, are more common in women, and are more appropriate to present with strangulation and require emergency surgery. This condition may lead to symptoms of bowel obstruction or strangulation and possible bowel resection-anastomosis. To the best of our knowledge, there is few reports of strangulated femoral hernia. We herein present an 82-year-old lady who presented with a 5-day history of abdominal pain, nausea and vomiting. On examination, the patient had a generalized tenderness and distention. The working diagnosis at this time was a bowel obstruction. A computed tomography scan revealed the hernia occurring medial to the femoral vessels and below the inguinal ligament. Laparotomy was performed and patient was treated successfully with surgical therapy. Hernia was repaired and a small bowel resection was performed with end to end anastomosis. The postoperative course was uneventful, and the patient was doing well at a 12-month follow-up visit. Obstructing femoral hernia of the small bowel is rare and the physician should suspect femoral hernia as a bowel obstruction cause.
Femoral hernia,Small Bowel Obstruction,Strangulation
https://beat.sums.ac.ir/article_44310.html
https://beat.sums.ac.ir/article_44310_15cf03745630d68fc221e0b04eade5b8.pdf
Shiraz University of Medical Sciences
Bulletin of Emergency And Trauma
2322-2522
2322-3960
4
Issue 1
2016
01
01
Transradial, Transscaphoid, Transcapitate, Perilunate Dislocation; A Case Report and Approach to the Patient
54
57
EN
Sarabjeet
Kohli
MGM Medical College, Navi Mumbai
kohli_jeet@yahoo.com
Vikram
Khanna
National Institute of Medical Sciences, Jaipur
86.khanna@gmail.com
Nilesh
Virani
MGM Medical College, Navi Mumbai
Hemant
Chaturvedi
National Institute of Medical Sciences, Jaipur
chaturvedi.hemant26@gmail.com
Carpal injuries are uncommon and are mainly seen in the younger age group. The incidence is unclear as many of the cases go undiagnosed. A 22-year-old male patient coming to the hospital after road traffic accident with head, face and left wrist injury. After immediate primary management the patient was taken up for a definitive procedure 4 days after the injury. Scaphoid fracture was fixed with the help of Herbert’s screw via the dorsal approach. The base of the first metacarpal was fixed with the help of JESS fixator and the distal end radius was fixed with the help of K-wires. The scapholunate and lunato triquetral ligaments were repaired. The whole construct was stabilized with the help of an external fixator. Postoperative period was uneventful. The external fixator was removed after 4 weeks and patient had a good functional outcome with the patient related wrist evaluation score coming out to be 11 at the end of the third month. This uncommon case of Transradial, Trans scaphoid, transcapitate, and perilunate dislocation was managed successfully with no postoperative complications and a good functional outcome.
Carpal injuries,Patient,Wrist evaluation score,JESS external fixator
https://beat.sums.ac.ir/article_44311.html
https://beat.sums.ac.ir/article_44311_48658766a9afc17e9c23e6388a27f455.pdf
Shiraz University of Medical Sciences
Bulletin of Emergency And Trauma
2322-2522
2322-3960
4
Issue 1
2016
01
01
Symptomatic Chiari Malformation with Syringomyelia after Severe Traumatic Brain Injury: Case Report
58
61
EN
Luis
Rafael
Moscote-Salazar
Universidad de Cartagena
mineurocirujano@aol.com
Nasly
Zabaleta-Churio
Gabriel
Alcala-Cerra
Andres
M.
Rubiano
Willem
Guillermo
Calderon-Miranda
Hernando
Raphael
Alvis-Miranda
Amit
Agrawal
dramit_in@yahoo.com
Chiari malformation Type I (CM-I) is a congenital disorder, which is basically a tonsillar herniation (≥ 5 mm) below the foramen magnum with or without syringomyelia. The real cause behind this malformation is still unknown. Patients may remain asymptomatic until they engender a deteriorating situation, such as cervical trauma. The objective of this case report is to give a broad perspective on CM-I from the clinical findings obtained in a patient with asymptomatic non-communicating syringomyelia associated with a CM-I exacerbated within 2 years of a TBI, and to discuss issues related to that condition.
Chiari Malformation type-I,Asymptomatic,Traumatic brain injury
https://beat.sums.ac.ir/article_44312.html
https://beat.sums.ac.ir/article_44312_f34235c8bda503a5561ff5676cf37b4b.pdf
Shiraz University of Medical Sciences
Bulletin of Emergency And Trauma
2322-2522
2322-3960
4
Issue 1
2016
01
01
The Role of Electronic Triage System in Management of Hospital Emergency Department
62
63
EN
Amin
Daemi
daemi.a@tak.iums.ac.ir
Electronic Triage System,Management,hospital,Emergency department
https://beat.sums.ac.ir/article_44313.html
https://beat.sums.ac.ir/article_44313_9b0d679630ffc16266a786fd1aa2f7c9.pdf