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Special Issue "Advances in Trauma Treatment"

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "General Surgery".

Deadline for manuscript submissions: 15 December 2023 | Viewed by 1902

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Special Issue Editors

Dr. Christoph Georg Wölfl
E-Mail Website
Guest Editor

Marienhaus Klinikum Hetzelstift, Klin Orthopadie Unfallchirurg & Sporttraumatol, D-67434 Neustadt, Germany
Interests: trauma, multi injured patients; ATLS

Dr. Dan Bieler
E-Mail Website
Guest Editor

Department of Trauma Surgery and Orthopaedics, Reconstructive Surgery, Hand Surgery and Burn Medicine, German Armed Forces Central Hospital Koblenz, Ruebenacher Strasse 170, 56072 Koblenz, Germany
Interests: trauma surgery; orthopedics

Special Issue Information

Dear Colleagues,

"Advances in Trauma Treatment" is a topic that focuses on the latest developments and techniques used in trauma treatment. These clinical advancements aim to improve the outcomes of patients who have experienced physical harm due to accidents, falls, or other traumatic experiences. The treatment of trauma injuries is crucial, as it often requires immediate surgical intervention by a skilled team of surgeons. Clinicians face challenges such as managing hypotension, preventing myocardial injury, identifying patients who require a trauma team, and stabilizing rib fractures in polytrauma cases. Differentiated hemotherapy after trauma, rehabilitation requirements for trauma centers, and risk factors that affect mortality in patients with hip fractures at regional trauma centers are the key areas of focus. The Journal of Clinical Medicine aims to present this topic with a view to enhancing the knowledge base of physicians and surgeons on new treatment options and best practices in the critical area of trauma care.

Dr. Christoph Georg Wölfl
Dr. Dan Bieler
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

trauma surgery
hypotension
myocardial injury
differentiated hemotherapy
trauma rehabilitation
rib fracture stabilization
major adverse cardiac events and epidemiology

Published Papers (3 papers)

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Open AccessArticle

Mortality Risk Factors of Severely Injured Polytrauma Patients (Prehospital Mortality Prediction Score)

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J. Clin. Med. 2023, 12(14), 4724; https://doi.org/10.3390/jcm12144724 - 17 Jul 2023

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Abstract

The aim of this study was to analyze the mortality of polytrauma patients and identify prediction parameters. A further aim was to create from the results a score for the prehospital predictive evaluation of 30-day survival. The study was conducted with a retrospective, observational design and was carried out unicentrically at a Level 1 Trauma Center. During the 4-year investigation period, patients with an Injury Severity Score (ISS) ≥ 16 were examined and their demographic basic data, laboratory values, and vital parameters were recorded. The mortality data analysis was performed using Kaplan–Meier Analysis and Log-Rank tests. Cox regressions were carried out to determine influencing factors and Receiver Operating Characteristic (ROC) curves were plotted to establish limit values for potential influencing factors. All statistical tests were conducted at a significance level of p ≤ 0.05. Coronary Heart Disease (CHD), cardiopulmonary resuscitation (CPR), age at admission, sex, and Glasgow Coma Scale (GCS) had a significant impact on the survival of polytrauma patients. The identified prediction parameters were combined with the shock index (SI). The generated score showed a sensitivity of 93.1% and a specificity of 73.3% in predicting the mortality risk. The study was able to identify significant influencing prehospital risk factors on 30-day survival after polytrauma. A score created from these parameters showed higher specificity and sensitivity than other prediction scores. Further studies with a larger number of participants and the inclusion of slightly injured patients could verify these findings. Full article

(This article belongs to the Special Issue Advances in Trauma Treatment)

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Open AccessArticle

Performing Advanced Trauma Life Support (ATLS) across Borders: Midterm Follow-Up of the Aeromedical Evacuation after Civilian Bus Accident at Madeira

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J. Clin. Med. 2023, 12(14), 4556; https://doi.org/10.3390/jcm12144556 - 08 Jul 2023

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Abstract

On 17 April 2019, a coach with tourists from Germany crashed in Madeira, requiring repatriation by the German Air Force. The Advanced Trauma Life Support (ATLS) concept was the central component of patient care. Data in Madeira were collected through a structured interview. The analysis of the Aeromedical Evacuation was based on intensive care transport records. In Germany, all available medical data sheets were reviewed for data collection. Quality of life (HRQoL) was evaluated by the 12-item Short Form Health Survey (SF-12). Twenty-eight prehospital patients were transported to the Level III Trauma Center in Funchal (Madeira). Five operative procedures were performed. Fifteen patients were eligible for Aeromedical Evacuation (AE). In the second hospital phase in Germany, in total 82 radiological images and 9 operations were performed. Hospital stay lasted 11 days (median, IQR 10–18). Median follow-up (14 of 15 patients) was 16 months (IQR 16–21). Eighty percent (8 out of 10) showed an increased risk for post-traumatic stress disorder (PTSD). Six key findings were identified in this study: divergent injury classification, impact of AE mission on health status, lack of communication, need of PTSD prophylaxis, patient identification, and media coverage. Those findings may improve AE missions in the future, e.g., when required after armed conflicts. Full article

(This article belongs to the Special Issue Advances in Trauma Treatment)

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Impairment of Mesenteric Perfusion as a Marker of Major Bleeding in Trauma Patients

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J. Clin. Med. 2023, 12(10), 3571; https://doi.org/10.3390/jcm12103571 - 20 May 2023

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Abstract

The majority of potentially preventable mortality in trauma patients is related to bleeding; therefore, early recognition and effective treatment of hemorrhagic shock impose a cardinal challenge for trauma teams worldwide. The reduction in mesenteric perfusion (MP) is among the first compensatory responses to blood loss; however, there is no adequate tool for splanchnic hemodynamic monitoring in emergency patient care. In this narrative review, (i) methods based on flowmetry, CT imaging, video microscopy (VM), measurement of laboratory markers, spectroscopy, and tissue capnometry were critically analyzed with respect to their accessibility, and applicability, sensitivity, and specificity. (ii) Then, we demonstrated that derangement of MP is a promising diagnostic indicator of blood loss. (iii) Finally, we discussed a new diagnostic method for the evaluation of hemorrhage based on exhaled methane (CH₄) measurement. Conclusions: Monitoring the MP is a feasible option for the evaluation of blood loss. There are a wide range of experimentally used methodologies; however, due to their practical limitations, only a fraction of them could be integrated into routine emergency trauma care. According to our comprehensive review, breath analysis, including exhaled CH₄ measurement, would provide the possibility for continuous, non-invasive monitoring of blood loss. Full article

(This article belongs to the Special Issue Advances in Trauma Treatment)

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