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Wyświetlanie 1-10 z 10
Tytuł:
Chest injuries based on Medical Rescue Team data
Autorzy:
Szarpak, Łukasz
Madziała, Marcin
Powiązania:
https://bibliotekanauki.pl/articles/1394596.pdf
Data publikacji:
2012
Wydawca:
Index Copernicus International
Tematy:
chest injuries
accident
epidemiology
pre-hospital care
Emergency Medical Service
Opis:
Injuries are the leading cause of death before the age of 40 years, and the third most common incidence of death worldwide after cardiovascular diseases and cancer. The aim of the study was to determine the number and type of chest injuries, based on EMS (Emergency Medical Service) documentation in the district of Otwock, with particular emphasis on patient age and gender at the time of injury. Material and methods. Analysis considered data obtained from medical rescue teams of Otwock County in 2009 concerning chest injuries. Results. The study group comprised 166 cases of chest injuries. Chest injuries were more often diagnosed in male patients. Most accidents occurred in the afternoon (between 1 and 6pm), and in the summer and winter seasons. Motor vehicle accidents and falls from heights were the most common cause of chest injuries, while the largest number of cases involved superficial chest injuries. Conclusions. Chest injuries accounted for 12% of all medical rescue team interventions, due to injuries, most often connected with superficial contusions of the chest wall. Rib fractures are usually caused by blunt chest injuries, most often relating to the V-VIII ribs. Fractures of the I-III ribs are rare and are evidence of a significant injury. Due to the flexibility of the thoracic wall, fractures in children are less common, as compared to the adult population. Most chest injuries occur in the afternoon during increased patient activity.
Źródło:
Polish Journal of Surgery; 2012, 84, 5; 247-252
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Hand injuries in polytrauma patients
Autorzy:
Żyluk, Andrzej
Fliciński, Filip
Pakulski, Cezary
Powiązania:
https://bibliotekanauki.pl/articles/1391601.pdf
Data publikacji:
2021
Wydawca:
Index Copernicus International
Tematy:
epidemiology
polytrauma
upper limb trauma
Opis:
Hand and forearm injuries are relatively rare in polytrauma patients; their incidence is estimated at 2–5%. Hand and forearm injuries are usually not life threatening, and, therefore are considered of secondary importance, replaced by serious injuries of other body parts. However, they should be treated immediately after stabilization of the general condition of patients, as their delayed management may result in serious dysfunction of the hand. The aim of this study was to determine the incidence, distribution and methods of treatment of hand and forearm injuries in patients treated at the Polytrauma Centre of the SPSK 1 in Szczecin over the period of 4 years. Medical records of 16 patients, 11 men (65%) and 5 women (35%) with a mean age of 34 years (range 19–62) who were treated at the Polytrauma Centre and sustained an additional injury to the hand and/or forearm were analyzed. Medical records of 16 patients, 11 men (65%) and 5 women (35%) at the mean age of 34 years (range 19–62) who were treated in Polytrauma Centre and sustained an additional injury to the hand and/or forearm were analysed. The most common component of polytrauma with associated hand injury was major bone fractures (spine, pelvis and extremities) – 12 cases (70%), followed by chest – 11 (65%), maxillofacial – 9 (53%), brain – 8 (47%) and abdominal injuries – 5 (29%). The most common injury of the distal upper limb was fracture of the distal radius – 9 patients (53%). Two patients sustained excessive crush-degloving injuries which were the primary cause of their admission to the Polytrauma Centre. Nine patients required surgery, predominantly fixation of the distal radius with a plate. All patients survived. The importance of the correct management of hand injuries performed promptly after stabilization of the general condition of polytraumatized patients was emphasized.
Źródło:
Polish Journal of Surgery; 2021, 93, 4; 21-27
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
The Comparison of Sharps Injuries Reported by Doctors Versus Nurses from Surgical Wards in the Context of the Prevalence of HBV, HCV and HIV Infections
Autorzy:
Gańczak, Maria
Bohatyrewicz, Andrzej
Korzeń, Marcin
Karakiewicz, Beata
Powiązania:
https://bibliotekanauki.pl/articles/1396722.pdf
Data publikacji:
2012-04-01
Wydawca:
Index Copernicus International
Tematy:
sharps injuries
blood-borne pathogens
HBV
HCV
HIV
prevalence
surgical staff
occupational exposure
occupational infection
Opis:
The aim of the study was to evaluate the nature and frequency of sharps injuries among doctors and nurses from the same surgical/gynecological wards and the prevalence of HBV/HCV/HIV infection.Material and methods. An anonymous cross-sectional sero-survey, with ELISA system used to detect anti-HBc, anti-HCV, anti-HIV, was conducted among 89 doctors and 414 nurses from 16 randomly selected hospitals in West Pomerania, Poland, between January-June 2009.Results. During the preceding 12 months, 82% doctors and 44.4% nurses (p<0.0001) had sustained at least one sharps injury; 12.3% doctors vs 2.2% nurses (p<0.003) sustained more than 10 injuries. The multivariable regression model revealed that being a doctor was associated with a greater odds (OR 4.2) of being injured with sharps. Sixty nine percent of nurses sustained a hollow-bore needle injury vs 8.9% doctors; p<0.001. Anti-HBc were found in 16.4% of doctors and 11.2% of nurses, p>0.28; anti-HCV - in 1.1% of doctors vs 1.4% of nurses, p>0.79; no anti-HIV positive cases were found. The analysis of potential risk factors for contracting a HBV revealed that for both job categories only length of employment was associated with an increased odds of being infected.Conclusions. Although the prevalence of HBV/HCV infection between doctors and nurses does not differ significantly, modifiable risk factors for contracting a BBI such as frequency and nature of sharps injuries may differ, which call for tailoring preventive measures to specific job categories. Long lasting exposure to injury events should be taken into consideration while assessing the risk for accuiring an occupational infection with HBV, HCV or HIV.
Źródło:
Polish Journal of Surgery; 2012, 84, 4; 190-195
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Postcholecystectomy bile duct injuries: evolution of surgical treatment
Autorzy:
Šileikis, Audrius
Žulpaitė, Rūta
Šileikytė, Auksė
Lukšta, Martynas
Powiązania:
https://bibliotekanauki.pl/articles/1392375.pdf
Data publikacji:
2019
Wydawca:
Index Copernicus International
Tematy:
Complications
laparoscopic cholecystectomy
bile duct injury
Opis:
Introduction: Bile duct injuries (BDIs) still occur during laparoscopic cholecystectomy. Although management of such complications is challenging, a collaboration of a multidisciplinary team and development of treatment methods and materials often lead to successful treatment. Materials and methods: Medical records of 67 patients who have experienced bile duct injuries after laparoscopic cholecystectomy were retrospectively reviewed. All injuries were classified according to the European Association for Endoscopic Surgery ATOM classification and investigated by the manifestation of the injury, surgical repair technique, early and late complications. Results: In 28 (41.8 %) patients with partial divisions, the surgical treatment of BDI was completed with endoscopic retrograde cholangiopancreatography (ERCP) and stenting while in 14 (20.1%) cases, the defect of bile duct was closed by suture. End-to-end ductal anastomosis was performed for 6 (13.4%) patients with complete division while 19 (28.3%) patients underwent hepaticojejunostomy. We followed up 58 (92.1%) of 63 patients. The mean follow-up duration was 25.7 (3 - 123) months. Twenty-three (39.7%) patients were found to have structures. Discussion: Intraoperative detection and management of BDIs are crucial to achieving good results. The routine intraoperative cholangiography and possibilities of repair by initial surgeons in peripheral hospitals remain controversial. Stenting with a covered self-expanding metal stent is promising for the patients with partial divisions of bile ducts. Initial hepaticojejunostomy is often a preferred treatment for transected bile ducts because of a lower rate of anastomosis strictures. However, an end-to-end anastomosis is more physiological, and endoscopy allows successful management of the strictures, we suggest choosing this treatment when possible Recommendation for paperwork content: Classifying bile duct injuries according to the new ATOM classification may be useful in choosing the most appropriate treatment in each case.
Źródło:
Polish Journal of Surgery; 2019, 91, 1; 14-21
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Is the Age of Patients with Iatrogenic Bile Duct Injuries Increasing?
Autorzy:
Stankiewicz, Rafał
Najnigier, Bogusław
Krawczyk, Marek
Powiązania:
https://bibliotekanauki.pl/articles/1395562.pdf
Data publikacji:
2015-03-01
Wydawca:
Index Copernicus International
Tematy:
cholecystectomy
complication
iatrogenic bile duct injury
Opis:
Resection of the gall-bladder is still the most common surgical procedure performed at general surgery departments. The laparoscopic method used in the majority of cases offers considerable benefits but at the same time is associated with an increased rate of bile duct complications. So far, a slim female aged 25-50 years was a typical patient with a iatrogenic bile duct injury. The aim of the study was to identify the age of patients with iatrogenic bile duct injuries as well as the clinical course observed in recent years. Material and methods. Gender and age structure of patients admitted to the Department of General, Transplant and Liver Surgery between the beginning of 2011 and June 2014 and treated for iatrogenic bile duct injuries, complications of laparoscopic cholecystectomy, were analysed. The patients were referred to the department as a reference centre. Results. In the group of 186 patients, females predominated (69.4%) and the mean age was 52 years. A considerable increase in the mean age of patients treated in 2014 as compared with previous years was seen. This was related to an increased rate of bile duct injuries in patients aged over 70 years, who accounted for about 25% of the group. In previous years, bile duct injuries in patients of such an advanced age happened considerably less frequently. Conclusions. A iatrogenic bile duct injury in an elderly person may prove a fatal complication. A repair surgery, i.e. the biliary-enteric anastomosis, is a major and burdensome procedure, particularly in the case of patients aged over 70 years. Special caution during laparoscopic cholecystectomy is advised in this population, and the slightest doubts should lead to conversion.
Źródło:
Polish Journal of Surgery; 2015, 87, 3; 129-133
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Iatrogenic bile duct injuries – clinical problems
Autorzy:
Głuszek, Stanisław
Kot, Marta
Bałchanowski, Norbert
Matykiewicz, Jarosław
Kuchinka, Jakub
Kozieł, Dorota
Wawrzycka, Iwona
Powiązania:
https://bibliotekanauki.pl/articles/1395690.pdf
Data publikacji:
2014-01-01
Wydawca:
Index Copernicus International
Tematy:
laparoscopic surgery
cholecystectomy
iatrogenic bile duct injury
Opis:
Laparoscopic cholecystectomy is one of the most frequently performed surgical procedures in surgical wards. Iatrogenic bile duct injuries (IBDI) incurred during the procedures are among postoperative complications that are most difficult to treat. The risk of bile duct injury is 0.2-0.4%, and their consequences are unpleasant both for the surgeon and for the patient. The aim of the study was analysis of iatrogenic bile duct injuries and methods of their repair,taking into consideration the circumstances, under which the injuries occur. Material and methods. The study group consisted of 16 patients who had suffered IBDI during surgery. The analysed parameters included sex, age, indications for surgery, the setting of the surgical procedure and the type of bile duct injury. Additionally, the time of injury diagnosis, type of repair and treatment outcome were assessed. The IBDI analysis used the EAES classification of injuries. The time of IBDI repair was defined as immediate, early or late,depending on the time that had passed from the injury. The analysis included complications seen after bile duct repair. Results. The study group consisted of 10 women and 6 men, aged 29-84. Patients underwent 6 classic cholecystectomies, 8 laparoscopic cholecystectomies, one gastrotomy to remove oesophageal prosthesis and one laparotomy due to peptic ulcer. IBDI was diagnosed intraoperatively in 4 patients. In 12 patients IBDI was diagnosed within 1-7 days. The diagnosis was based on endoscopic retrograde cholangiopancreatography and the results of biochemistry tests. According to the EAES classification, the injuries were of type 1 (4 patients), type 2 (8 patients), type 5 (3 patients) and type 6 (1 patients). Reconstruction procedures were performed during the same anaesthesia session in 3 patients, and in the early period in 13 patients. The main procedure was Roux-en-Y anastomosis (12 patients), with the remaining including bile-duct suturing over a T-tube (3 patients) and underpinning of an accessory bile duct in the pocket left after gallbladder removal (1 patient). The most common reconstruction complications included bile leak (3 patients), recurrent cholangitis (3 patients) and bile duct stricture (2 patients). Mortality in the study group was 12.5%. Conclusions. The procedures of laparoscopic and classic cholecystectomy are associated with a risk of IBDI, especially in the presence of inflammatory state of the gall-bladder. IBDI is a complex complication: its treatment poses a challenge for the operating surgeon, and even the most careful treatment adversely affects the patient’s lifedue to complications.
Źródło:
Polish Journal of Surgery; 2014, 86, 1; 17-25
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
The results of the treatment of hand – Outcomes of the treatment of hand degloving injuries with greater omentum flaps
Autorzy:
Żyluk, Andrzej
Szlosser, Zbigniew
Puchalski, Piotr
Powiązania:
https://bibliotekanauki.pl/articles/1392104.pdf
Data publikacji:
2019
Wydawca:
Index Copernicus International
Tematy:
degloving injury
hand reconstruction
omental flap
soft tissue loss
Opis:
Degloving injury consists in tearing out the soft-tissue integument from skeleton of the hand, with accompanied nerves and vessels. The whole hand degloving has bad reputation and one of worst prognosis, even worse than total hand amputation. The range of possible salvage procedures in these cases is limited and their outcomes are unsatisfactory. One of the suitable methods is wrapping the skinned hand with pedicled or free greater omentum flap, retrieved from the abdominal cavity. The article reports outcomes of the treatment of 5 patients at a mean of 8 years after total degloving of their hands and coverage with omental flaps. All flaps healed uneventfully, but in none of the patients the whole length of the fingers was preserved. Division of stumps of 3 fingers was possible in one patient, two others had three-digital hands and remaining two had only separated thumb. Dexterity of injured hands was limited with a mean of score DASH questionnaire of 43 points. Quality of life as measured by SF-36 questionnaire was fair (58 and 53 points in physical and mental domain, respectively). Regardless this, all patients were satisfied with achieved outcomes and all returned to work, which was a confirmation of the effectiveness of the method used in their treatment.
Źródło:
Polish Journal of Surgery; 2019, 91, 6; 20-27
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Do surgeons use double gloves during surgery? Results of a survey
Autorzy:
Walczak, Dominik
Grajek, Maciej
Pawełczak, Dariusz
Żółtaszek, Agata
Szumniak, Ryszard
Czarnecki, Marek
Trzeciak, Piotr
Krakowczyk, Łukasz
Maciejewski, Adam
Pasieka, Zbigniew
Powiązania:
https://bibliotekanauki.pl/articles/1391524.pdf
Data publikacji:
2021
Wydawca:
Index Copernicus International
Tematy:
needlestick injuries
surgical gloves
surveys and questionnaires
Opis:
Introduction: The perforation of gloves during surgical procedures is quite common. A cheap and quite effective method of reducing the risk of blood-borne infections is wearing two pairs of gloves. Unfortunately, some surgeons are reluctant to it, and they report decreased dexterity and sensation. The aim of the study was to evaluate surgeons’ double-gloving practices to determine the factors related to compliance. Material and methods: An anonymous, 21-question survey in Polish was sent by post to 41 surgical departments. The questions concerned: demographic data, type of surgical gloves used, allergy to latex, number of surgeries performed, frequency of using double gloves and negative impressions from using them and finally, the frequency of needlestick injuries during surgical procedures. Results: We received 179 questionnaires back. More than 62% of the surgeons believe that double gloves provide better protection than a single pair, 24% do not believe in this, and 14% have no opinion. Only 0.6% of respondents always use double gloves during surgery, 19% double glove in at least 25% of cases and 68% do it occasionally. 13% of the surgeons declared that they had never worn double gloves. During high-risk procedures, 86% of respondents wear double gloves. About half of respondents (50.3%) report discomfort while wearing double gloves; 45% – decreased dexterity; about 30% complain of numbness and tingling; and 64% – decreased sensation. Conclusion: Due to the high number of surgical glove perforations and relatively high prevalence of needlestick injuries, it is necessary to use methods that reduce the risk of transmission of pathogens. The habit of using a double pair of gloves should be implemented especially among young surgeons starting to train in their specialities. Consequently, the period of initial discomfort will be combined with the acquisition of surgical skills, which will allow for gradual acclimatization.
Źródło:
Polish Journal of Surgery; 2021, 93, 1; 9-14
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Iatrogenic Bile Duct Injury. A Significant Surgical Problem. Assessment of Treatment Outcomes in the Departments Own Material
Autorzy:
Bobkiewicz, Adam
Krokowicz, łukasz
Banasiewicz, Tomasz
Kościński, Tomasz
Borejsza-Wysocki, Maciej
Ledwosiński, Witold
Drews, Michał
Powiązania:
https://bibliotekanauki.pl/articles/1396002.pdf
Data publikacji:
2015-03-01
Wydawca:
Index Copernicus International
Tematy:
iatrogenic bile duct injuries
cholecystectomy
complications
Opis:
Iatrogenic bile duct injuries (BDI) are still a challenging diagnostic and therapeutic problem. With the introduction of the laparoscopic technique for the treatment of cholecystolithiasis, the incidence of iatrogenic BDI increased. The aim of the study was a retrospective analysis of 69 patients treated at the department due to iatrogenic BDI in the years 2004-2014. Material and methods. In this paper, we presented the results of a retrospective analysis of 69 patients treated at the Department due to iatrogenic BDI in the years 2004-2014. The data were analysed in terms of age, sex, type of biliary injury, clinical symptoms, the type of repair surgery, the time between the primary surgery and the BDI management, postoperative complications and duration of hospital stay. Results. 82.6% of BDI occurred during laparoscopic cholecystectomy, 8.7% occurred during open cholecystectomy, whereas 6 cases of BDI resulted from surgeries conducted for other indications. In order to assess the degree of BDI, Bismuth and Neuhaus classifications were used (for open and laparoscopic cholecystectomy respectively). 84.1% of patients with confirmed BDI, were transferred to the Department from other hospitals. The average time between the primary surgery and reoperation was 6.2 days (SD 4). The most common clinical symptom was biliary fistula observed in 78.3% of patients. In 28 patients, unsuccessful attempts to manage BDI were made prior to the admission to the Department in other centres. The repair procedure was mainly conducted by laparotomy (82.6%) and by the endoscopic approach (15.9%). Hepaticojejunostomy was the most common type of reconstruction following BDI (34.7%). Conclusions. The increase in the rate of iatrogenic bile duct injury remains a challenging surgical problem. The management of BDI should be multidisciplinary treatment. Referring patients with both suspected and confirmed iatrogenic BDI to tertiary centres allows more effective treatment to be implemented.
Źródło:
Polish Journal of Surgery; 2014, 86, 12; 576-583
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
An analysis of causes of trauma, spectrum of injuries and treatment outcomes in patients treated at Multitrauma Centre of the University Teaching Hospital No 1 in Szczecin in 2015. Comparison of results from years 2015 and 2007
Autorzy:
Dziubiński, Dawid
Abramczyk, Urszula
Ciechanowicz, Dawid
Kozłowski, Jan
Pakulski, Cezary
Żyluk, Andrzej
Powiązania:
https://bibliotekanauki.pl/articles/1392142.pdf
Data publikacji:
2019
Wydawca:
Index Copernicus International
Tematy:
abdominal injury
epidemiology
mortality
multitrauma injury
Opis:
Introduction: Multitrauma is defined as injury involving two or more different body parts, with a condition that at least one of these injuries is life-threatening. They represent serious traumas, requiring treatment in the intensive care units and frequently surgical intervention. Aim: The objective of this study was epidemiological and clinical analysis of patients treated in 2015 year in Multitrauma Centre of the University Teaching Hospital no 1 in Szczecin, and comparison the results with outcomes of similar study conducted in the same Centre in 2007 year. Material: Clinical material comprised medical notes of 82 patients, 52 men (63%) and 30 women (37%), with a mean age of 44 years, who sustained multitrauma injuries. An analysis included causes of traumas, spectrum of injuries, involvement of body parts, methods and outcomes of the treatment. Results: The most common cause of multitrauma was traffic accident – 45 cases (55%), followed by fall from height – 22 (27%) and other mechanism – 15 (18%). The most frequent component of multitrauma made bone fractures (spine, pelvis, limbs) – 64 cases (78%), followed by head traumas – 63 (77%), chest – 53 (65%) and abdominal 30 (36%) injuries. A total of 48 patients (58%) required surgical intervention, the most frequently fixation of bone fractures – 24 patients (29%), repair of abdominal and head injuries – 18 (22%) either. Of 82 treated patients 64 (78%) survived and 18 (22%) died. A mean period of stay in Multitrauma Centre was 23 days for survived patients and 17 days for those who died. Comparing to similar analysis conducted 8 years earlier, a change in involvement of particular body parts comprising multitrauma injury was observed: number of head injuries increased of 14%, number of chest traumas and bone fractures decreased of 21% and 11%, respectively. The survival rate improved of 10%.
Źródło:
Polish Journal of Surgery; 2019, 91, 4; 29-35
0032-373X
2299-2847
Pojawia się w:
Polish Journal of Surgery
Dostawca treści:
Biblioteka Nauki
Artykuł
    Wyświetlanie 1-10 z 10

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