Timely hemorrhage control is paramount in trauma; however, a critical time interval from emergency department arrival to operation for hypotensive gunshot wound (GSW) victims not established. We hypothesize that delaying surgery more than 10 minutes increases all-cause mortality patients with GSW.Data of adults (n = 309) hypotension and GSW the torso requiring immediate January 2004 September 2013 were retrospectively reviewed. Patients resuscitative thoracotomies, traumatic brain injury,...

Hypercoagulability is a homeostatic response to trauma, but relatively little information available about coagulation changes after burn injury. Therefore, we tested the hypothesis that patients are hypercoagulable at admission and/or during recovery.A prospective observational trial was conducted an American Burn Association verified Center. Thromboelastography (TEG) performed on blood drawn from indwelling catheters upon and weekly for those who remained hospitalized. Routine special tests...

The incidence of occult pneumothorax (OPTX) has dramatically increased since the widespread use computed tomography (CT) scanning. OPTX is defined as a not identified on plain chest X-ray but detected by CT scan. overall reported about 5% to 8% all trauma patients. We conducted 5-year review our and asked if an objective score could be developed better quantify OPTX. This in turn may guide practitioner with decision observe these patients.This retrospective patients Level I university center...

To characterize the descriptive and molecular epidemiology of Acinetobacter baumannii in our hospital.Longitudinal analysis electronic microbiology laboratory records isolates.A 1,500 bed public teaching hospital Miami area.Consecutive patients with A. from January 1994 to December 2011.None: Data on all isolates were clustered at patient level, first isolate per single was determined. Yearly trends analyzed based carbapenem susceptibilities originating units for blood unique patient....

To establish the presence of air contamination with Acinetobacter baumannii in trauma ICU.Point prevalence microbiological surveillances.A 1,500-bed public teaching hospital Miami metro area.Trauma ICU patients.Pulsed field electrophoresis was performed on environmental and clinical isolates to determine association any from isolates.Out 53 patient areas cultured, 12 (22.6%) had their positive for A. baumannii. The an baumannii-positive (underneath plate) associated cultures (11 21 [52.4%]...

Pediatric lower extremity vascular injuries (LEVI) are rare but can result in significant morbidity. We aimed to describe our experience with these injuries, including associated injury patterns, diagnostic and therapeutic challenges, outcomes.

Abstract Introduction The financial burden patients face due to healthcare costs is known as toxicity. Burn survivors are at high risk for toxicity given that their injuries can result in significant disability, lead ongoing chronic medical issues, and often require treatment with multiple surgeries. Our study aim was identify factors a nationwide sample of burn survivors. We hypothesized would be more common the first few years after injury. Methods A survey distributed through Phoenix...

Abstract Introduction There is growing interest in the use of marijuana and its derivatives for treating a variety symptoms including chronic neuropathic pain, sleep disturbances, anxiety. However, patterns among burn survivors unknown. The aim this study was to examine nationwide sample survivors. We hypothesized that would be frequent common reporting pain. Methods A survey distributed through Phoenix Society Burn Survivors adult across US (March-June 2023). elicited demographics, history,...

Abstract Introduction Extracorporeal membrane oxygenation (ECMO) is an effective therapy for severe acute respiratory distress syndrome (ARDS), but its use in burn patients uniquely challenging due to bleeding risk associated with frequent operations. We aimed characterize a case series of the hypothesis that ECMO feasible appropriately selected patients. Methods All treated from November 2021 August 2024 at one center were retrospectively reviewed. Revised-Baux scores (r-BS) and Respiratory...

The objective of this study was to determine the incidence drug resistance among isolates Acinetobacter baumannii from our Burn Intensive Care Unit (BICU), rate clinical cure, and mortality rate. We undertook a retrospective review all cases infection BICU between January 2004 November 2005. group consisted 24 men (80%) 6 women with mean age 43 years (range, 17–76 years, ±14.5 years). Mean TBSA burned 43% 9–75%, ±19%). length stay 49 days 5–118 days, ±30 days). Patients developed their first...

Despite recent improvements in analgesia, pain control during dressing changes continues to be a major challenge patients with burns. We investigated two different modalities compare how much the patient experienced and after change. Patients partial-thickness burns that required only topical wound care were assigned randomly treatment Acticoat (Smith Nephew USA, Largo, FL) or silver sulfadiazine (AgSD). The outcome variable was care, which measured using visual analog scores. mean scores...

Traumatic vascular injuries of the lower extremity in pediatric population are rare but can result significant morbidity. We aimed at describing our experience with such complex injuries, associated patterns injury, diagnostic and therapeutic challenges, outcomes.From January 2006 to December 2011, 2,844 trauma patients presented Ryder Trauma Center, an urban Level I center Miami, Florida. Among them, 18 (0.6%) were evaluated for traumatic injuries. Variables collected included age, sex,...

We aimed to determine the association between environmental exposure carbapenem-resistant Acinetobacter baumannii and subsequent risk of acquiring this organism. Patients exposed a contaminated hospital environment had 2.77 times A. than did unexposed patients (relative risk, [95% confidence interval, 1.50-5.13]; P = .002).

The American Board of Surgery In-Training Examination (ABSITE) is designed to measure progress, applied medical knowledge, and clinical management; results may determine promotion fellowship candidacy for general surgery residents. Evaluations are mandated by the Accreditation Council Graduate Medical Education but administered at discretion individual institutions not standardized. It unclear whether ABSITE evaluations form a reasonable assessment resident performance.To favorable...

Background Stem cell therapy holds promise to improve healing and stimulate tissue regeneration after burn injury. Preclinical evidence has supported this; however, clinical studies are lacking. We examined the application of bone marrow-derived mesenchymal stem cells (BM-MSC) deep second-degree injuries using a two-dose escalation protocol. Methods Ten individuals aged 18 years or older with wounds were enrolled. The first five patients administered 2.5 × 10³ BM-MSC/cm 2 their wounds. After...

There continues to be debate about the routine use of deep vein thrombosis (DVT) prophylaxis in burn patients. The concern is that may lead adverse events. hinges on incidence DVT and its relation risk-benefit ratio. This study seeks estimate true rate patients, evaluate possible risk factors development. Nationwide Inpatient Sample was queried for all patients with age ≥18 years ICD-9 codes injuries. Demographic data, comorbidities, length stay, total charges, procedures, presence central...

Inflammation and hypermetabolism post burn predisposes to hyperglycemia insulin resistance. The authors hypothesize that admission predicts infectious outcomes. A retrospective review of all patients greater than 20 years age admitted for initial management from January 2008 December 2013 was conducted. Nonthermal injuries, transfers, those without glucose or histories were excluded. Hyperglycemia defined as ≥150 mg/dl. Patients grouped follows: euglycemic diabetes (control), with (-H+D),...

Gastrostomy tubes are used for primary and supplemental feeding gastric decompression. The purpose of the study was to compare complication rate gastrostomy tube placement by either endoscopic or fluoroscopic technique. Between 1996 2004, surgical radiological services at a Level I trauma hospital placed in 378 patients (endoscopy = 268, fluoroscopy 110). percutaneous group comprised 71% cohort with mean age 51 ± 21 (range: 1–93 years age), radiographic remaining (29%) 57 19 17–95 age)....