International Journal of Burns and Trauma最新文献

In clinical practice, tracheal intubation entails flexing a tracheal tube with a stylet and inserting it into the glottis under the guidance of videolaryngoscopy. Nevertheless, this approach may trigger intense sympathetic responses and elevate the risk of intubation failure. To address these issues, our research team put forward a minimally invasive intubation technique by using SEE-VL and SEEK^flex, which is anticipated to enhance the first-pass success rate of intubation and mitigate stress reactions. This novel technology is expected to minimize the trauma associated with intubation and improve patients' comfort during medical treatment.

Objective: The purpose of this scoping review is to compile the evidence regarding the use of computed tomography (CT) to distinguish between benign and malignant vertebral compression fractures (VCFs) in artificial intelligence (AI) applications.

Methods: We systematically searched PubMed/MEDLINE, DOAJ, and ScienceDirect through October 2025 for studies reporting AI-based diagnostic approaches (machine learning with radiomics features, deep learning with convolutional neural networks, or hybrid models) applied to CT images in adult patients with VCFs. Eligible studies required diagnostic performance metrics and definitive reference standards.

Results: Six retrospective studies from Asia and Europe have been found, involving 1,767 participants with 3,408 vertebrae, including 1,257 benign and 1,442 malignant vertebral fractures. The diagnostic performance of AI algorithms is high, achieving an area under the curve (AUC) score from 0.76 to 0.99. Deep learning approaches achieved performance comparable to experienced radiologists, while radiomics-based methods provided interpretable quantitative features. Hybrid models combining both approaches showed synergistic benefits. Three studies with external validation confirmed reasonable generalizability, though with some performance reduction in independent datasets.

Conclusions: AI-assisted evaluation of CT scans also has good potential in differentiating benign from malignant VCFs, which could reduce unnecessary MRI referrals and improve the initial evaluation time. However, the data regarding this are limited because of retrospective studies with variable methods and limited multicenter data, which are still required to implement this in routine clinical practice.

A bony mallet finger refers to an avulsion fracture at the dorsal base of the distal phalanx. When the fracture fragment involves more than one-third of the articular surface and is accompanied by volar subluxation of the DIP joint, the joint's stability is compromised. In this setting, surgical treatment is often necessary. Open reduction and hook plate fixation provide the most rigid fixation and have become increasingly popular. However, surgical approaches - including Y-, H-, S-, and U-shaped incisions - are frequently associated with complications such as skin necrosis, nail deformity, and implant extrusion. Treating bony mallet finger with a hook plate is challenging. This retrospective case series study involved a review of 26 patients who underwent surgical treatment for bony mallet finger between May 2019 and December 2022. Our objective is to describe a novel surgical approach using double parallel dorsal longitudinal incisions for fixing mallet fractures. Additionally, we provide the preliminary results to evaluate its effectiveness.

Background: Traumatic brain injury (TBI) induces systemic responses, including neurogenic cardiac injury via the brain-heart axis, manifesting as electrocardiographic (ECG) abnormalities that may predict outcomes.

Objective: This systematic review aimed to evaluate the diagnostic and prognostic utility of ECG monitoring in patients with TBI, identify knowledge gaps, and guide future research.

Methods: Following PRISMA guidelines, we searched PubMed and Google Scholar (January 2020 - March 2025) for studies on adult patients with TBI (≥ 16 years) who underwent acute ECG assessment (≤ 72 hours post-injury). The inclusion criteria focused on observational/cohort studies that reported ECG changes, severity correlations, and outcomes. The exclusion criteria were pediatric cases, pre-existing cardiac conditions, and non-English articles. Data were extracted from the eligible studies.

Results: Six studies (1,642 patients) revealed ECG abnormalities in 10-88% of cases, increasing with TBI severity (e.g., prolonged QTc in 3% of mild cases vs. 15% of severe cases). Common changes included repolarization issues (QTc prolongation and ST-segment/T-wave alterations), arrhythmias, and conduction disturbances. Abnormalities often resolved within days, improved post-neurosurgery (e.g., reduced QTc), and predicted mortality (e.g., QTc prolongation/ST depression as independent factors) and cardiac dysfunction.

Conclusion: ECG changes are prevalent in TBI, correlate with severity, and have prognostic value for risk stratification. Routine monitoring is recommended, and larger, standardized studies are needed to optimize management.

Delayed evacuation creates a critical gap between point-of-injury care and definitive surgical management in battlefield trauma. Although Damage Control Orthopedics (DCO) is an established strategy for physiologically unstable trauma patients, it is usually implemented after evacuation and depends on higher-level medical support. We propose Battlefield Monitoring and Stabilization (BMS) as a forward-deployed conceptual framework for earlier battlefield care. BMS emphasizes temporary stabilization, hemorrhage-oriented intervention, basic physiological support, and portable monitoring before evacuation and definitive treatment. Proposed applications include point-of-injury stabilization, prolonged field care, and en-route casualty management. Several enabling components, including a rapidly assembled pelvic stabilization device, are under development. Relevant evaluation domains include fixation speed, hemostatic performance, monitoring accuracy, portability, and environmental adaptability. Further validation is warranted.

This systematic review looks at burn injuries in the Gulf region over the past five years, focusing on how often they occur, their survival and complication rates, and current prevention efforts. To gather the data, two reviewers independently searched five major databases and checked article reference lists to make sure no relevant studies were missed. The team then used the Newcastle-Ottawa Scale (NOS) to evaluate the quality and potential bias of the gathered research. The following sections present these regional findings and discuss the need for better burn management systems and stronger prevention strategies across the Gulf countries.

Objectives: (1) To examine burn epidemiology. (2) To assess morbidity and mortality. (3) And to cover preventative strategies in the gulf countries (Qatar, UAE, Oman, Bahrain, Saudi Arabia) over the past 5 years.

Methods: (1) Data extraction was performed independently by two reviewers utilizing a standardized form. To ensure data integrity, this instrument was initially piloted on three studies, with iterative modifications implemented as necessary before full-scale deployment. (2) A systematic literature search was conducted across five major electronic databases: PubMed, Embase, Google Scholar, Web of Science, and Scopus. To ensure literature saturation, the reference lists of all relevant articles were manually screened to identify additional eligible studies.

Results: (1) A quantitative meta-analysis was precluded by substantial heterogeneity in study methodologies, patient cohorts, and outcome assessments. Regarding methodological quality, twelve trials (60%) exhibited a moderate risk of bias, while two demonstrated a low risk and four presented a high risk. Evaluation via the Newcastle-Ottawa Scale (NOS) indicated that nine to ten studies maintained high transparency in both data collection and methodological reporting. (2) Highest rate of mortality was found in saudi arabia (17.6%) and second highest in Kuwait (10.9%).

Conclusions: (1) There is a high degree of variation in burn epidemiology, mortality, and prognosis among various Gulf countries. Which emphasizes a need for a uniform burn management system. (2) To effectively reduce burn-related morbidity and mortality, a comprehensive escalation of current preventative strategies is required.

With the transition to large-scale combat operations (LSCOs) and distributed warfare in theatre, medical evacuation times could be a lot longer, which challenges the "golden hour". In response to this challenge, the paper presents the "Core Region of Combat Trauma (CRCT)" as a novel framework for directing care in the Prolonged Casualty Care (PCC) phase when evacuation is prolonged. The CRCT is the site of injuries which are among the leading causes of potentially preventable deaths following Tactical Combat Casualty Care (TCCC). The care of CRCT located in the transitional phase between TCCC and damage control surgery. The guiding principle of CRCT management is damage control and physiological maintenance. This methodology facilitates the transition of casualties from a state where evacuation is not feasible to one where evacuation is tolerable.

Objective: This systematic review aimed to conduct a comprehensive comparative analysis of the diagnostic performance of magnetic resonance imaging (MRI) and ultrasound (US) in detecting rotator cuff tears (RCTs).

Methods: A systematic literature search was conducted in the PubMed, Scopus, and Embase databases from January 2021 to March 2025 for original studies on adults (≥18 years) with suspected RCTs undergoing both US and MRI. Thirteen studies involving 792 participants met the inclusion criteria.

Results: US was better than MRI for full-thickness tears, with a sensitivity of 100% (especially for supraspinatus), a specificity of 81-100%, and a kappa of up to 1.0. For partial-thickness tears, the results varied (sensitivity 72-94%, accuracy 76-94%). Non-supraspinatus tendons were less reliable, and the results were affected by the operator's skill, the patient's sex (worse in females), and the side of the body. MRI was better for partial tears, complicated cases, and planning surgery.

Conclusion: The findings demonstrate that US can serve as a valuable auxiliary imaging modality for rotator cuff evaluation, particularly excelling in detecting full-thickness tears when MRI is contraindicated, unavailable, or in resource-limited settings. While US shows excellent diagnostic performance for full-thickness supraspinatus tears, MRI remains the primary diagnostic standard in clinical practice for comprehensive rotator cuff assessment, particularly for partial tears, complex pathologies, and detailed pre-operative planning.

In this article we present a case of a large anterior elbow defect and an ipsilateral post-mastectomy defect reconstructed simultaneously using a single latissimus dorsi pedicle flap, split into two separate skin islands based on its independent vascular branches. To the best of our knowledge, no previous cases utilizing this approach for simultaneous treatment of mastectomy and distal arm tissue defects have been reported. Therefore, it was deemed relevant to share the technical aspects of the surgical procedure. The case involves a 61-year-old woman of Caucasian origin, diagnosed with breast cancer of the left breast. She underwent a modified radical mastectomy. Postoperative radiotherapy and chemotherapy were administered. During a chemotherapy infusion, extravasation of the chemotherapeutic agent led to necrosis in the left elbow and distal upper arm regions. The patient was primarily treated at another facility with skin grafting. We performed a reconstruction with a pre-expanded latissimus dorsi pedicle flap divided into two independent myocutaneous flaps for the upper extremity and mastectomy defects. The left breast underwent delayed combined reconstruction with the myocutaneous flap and a silicone implant. The upper extremity defect was simultaneously reconstructed with the other part of the same flap. The whole reconstruction included three operative stages. The blood supply to the transferred tissues was excellent and no complications occurred. The constant vascular anatomy of the thoracodorsal vessels and their intramuscular distribution pattern provides a robust amount of healthy tissue, which can be successfully used for treating a variety of defects within the flaps rotational arc. This allows for the reconstruction of different anatomical regions. Based on this case we demonstrate that coverage of a large elbow defect and simultaneous breast reconstruction is possible by splitting a pre-expanded pedicle latissimus dorsi flap into two independent flaps.

Objective: This study aimed to investigate the clinical application of Wound Care Ointment combined with Vaseline gauze for the repair of split-thickness skin graft donor sites.

Methods: A total of 64 patients who met the inclusion criteria were included. The study group (32 patients) used Vaseline gauze lined with Wound Care Ointment to close the split - thickness skin graft donor sites, while Vaseline gauze was applied directly to the donor sites in the control group (32 patients). Demographic data, wound infection conditions, epithelialization time, the time of the first postoperative outer gauze replacement, Visual analogue scale (VAS) during the first postoperative outer gauze change and the number of layers of bleeding gauze were recorded for the selected patients.

Results: The epithelialization time of the donor site wound in the study group was significantly shorter than that in the control group [(10.09±0.93) days vs. (10.78±0.94) days, P<0.05]; VAS for the first postoperative change of the outer gauze in the study group was lower than that in the control group (2.47±0.84 vs. 3.53±1.14, P<0.05); the time for the first postoperative change of the outer gauze in the study group was later than that in the control group [(6.38±0.91) days vs. (5.78±1.26) days, P<0.05]; and the number of layers of bleeding gauze during the first postoperative change of the outer dressing in the study group was less than that in the control group (6.72±1.02 vs. 7.50±1.08, P<0.05).

Conclusion: Wound Care Ointment is beneficial for the wound healing of split-thickness skin graft donor sites, which prolongs the first postoperative dressing change, reduces pain during the removal of the inner layer dressing, provides excellent wound protection and shortens the healing time. Therefore, Wound Care Ointment can be recommended for the repair of split-thickness skin graft donor sites.