جستجوی مقالات مرتبط با کلیدواژه « gunshot » در نشریات گروه « پزشکی »

The current study aimed to successively assess the applicability of trauma scoring systems.

To evaluate the outcomes, prognosis, and mortality in trauma patients.

The present study was conducted on all 221 injured patients referred to Shahid Rajaee Hospital from January 2014 toDecember 2020 with International Classification of Diseases-10th Revision (ICD-10) injury mechanism codes of W32.0-34.09, indicating afirearm injury. Univariate analysis and Chi-square test were employed to discover the individual relationship between each variable andthe injury outcome. Logistic regression analysis was performed to control the confounder. Finally, the area under the Receiver OperatingCharacteristic (ROC) curve was used to compare the predictive efficiency of the injury severity scales.

The mortality rate of the gunshot was 15 (6.78%). The cause of the gunshot was related to assaults in 73.68% of the survivingpatients. Meanwhile, suicide attempt was the second cause of death in gunshot patients (16.67%). Most of the injuries that occurredamong 20-24-year-old patients resulted from assaults. The odds of mortality in gunshot victims increased by 4.25 times (95% CI [1.99,9.10]) for each additional unit AIS. In the random forest model, the Trauma Injury Severity Score (TRISS) was the most importantmortality predictor. The TRISS was the highest area under the ROC curve for death prediction among firearms gunshot patients.

Injury Severity Score (ISS) had the least, and TRISS had the most area under the curve. Therefore, TRISS was found to be thebest predictor in determining the death or survival of firearms gunshot patients.

Gunshot wound injuries to penile are relatively infrequent.

This study aimed at reviewing the patterns of gunshot injuries to the penile and their treatments.

In November 2019, PubMed (MEDLINE), Scopus, Embase, ISI web of sciences and Google Scholar databases were searched for finding relevant studies. For this reason, various meshes and keywords were used to search including wound/injury, genitalia/genitourinary, Gunshot/war/explosion/firearm/military, penile/penis, scrotum, and urethral.

Of the five included studies, three studies were related to civilian gunshot injuries and two studies were related to war-injury. The average age of patients was in the range of 28-31 years old. The major gunshot penile injuries were Corporotomy, Corpus cavernosum, superficial penile wounds, and urethral injury. The most frequent concomitant damages were injuries to adjacent anatomies, including thigh injury, scrotal/testicular, abdominal organs, bladder, and rectum. There are several surgical procedures depending on the degree of gunshot penile injuries such as surgical exploration, closing the residual penile stump of a partly amputated penis, penile degloving, penoscrotal approach, simple suturing, hemostatic suturing of Buck’s fascia and skin, and surgical re-anastomosis or total replacement with phallic reconstruction.

Penile gunshot injuries often are concomitant with other severe injuries in adjacent anatomies, which have a negative impact on the mortality of victims. For the management of these cases, it is essential to evaluate the length and size of and type of weapons.

Outcomes of patients undergoing damage control laparotomy (DCL) for abdominal gunshot wounds (GSWs) remains relatively unknown. The purpose of this study was to evaluate the impact of DCL on long term morbidity and survival.

This retrospective study was conducted on patients undergoing a damage control laparotomy for abdominal GSWs. The data were collected using 50 consecutive trauma patients over a 4.5-year-period between August 1st, 2004 and September 30th, 2009. The patients were classified regarding the characteristics, such as age, perioperative physiological parameters, trauma indices, number of abdominal GSWs, critical care unit stay, hospital length of stay, morbidity, and mortality. Univariate and multivariate logistic regression was employed to compute the odds of survival and estimate the unadjusted and adjusted association between these factors.

According to the results, the majority of the patients were male (96%) with a mean age of 29.7 years who had a single abdominal gunshot wound (60%). Liver injuries (58%) followed by small bowel (44%), majors venous (40%), and colonic (38%) trauma were observed in the patients. The overall mortality rate was obtained at 54%. The mean length of intensive care unit stay and mean hospital length of stay were 7 and 13 days, respectively. Factors associated with a decreased odds of survival included Penetrating Abdominal Trauma Index (PATI) > 25, intra-operative blood lactate level > 8 mmol/L, and massive transfusion >10 units packed red blood cells.

After controlling the confounding factors, a PATI score of > 25 was associated with a decreased odds of survival (OR: 0.20, P=0.04).

 Management of maxillofacial gunshot wounds (MGSWs) has long been challenging and a multidisciplinary approach in planning and reconstructing of MGSWs should be followed. The objective of this study was to retrospectively assess and present gunshot wound cases in a hospital in Iran. 

 Fourteen MGSW at Departments of Oral and Maxillofacial Surgery at Jundishapur and Shahid Sadoughi Universities of Medical Sciences from 2011 to 2015 were retrospectively reviewed. Data was analyzed using SPSS version 16.0. Data was presented in the form of descriptive statistics: mean and standard deviation for all quantitative variables and frequency and percentages were presented for qualitative variables like gender, entry site of projectile, etc. 

 Age ranged from 18 to 42 years with mean of 27.34 years. There were 12 (85.7%) male and 2 (14.3%) female cases. From them, Ten (71.5%) patients required airway management. Mandible was the most frequent involved site (i.e, in 11 (78.5 %) patients), while midface was involved in 3 (21.5%) patients. Suicide was the main cause of gunshot (i.e, in 8 (57.1%) patients). Free fibular flap was applied in 4 (28.5%) patients, while 8 (57.1%) patients were managed with regional and distant flaps in combination with reduction internal fixation. The most common type of treatment was two stage delayed reconstruction (35.7%). Most of the patients (i.e, in 12 (85.7%) patients) had complications which trismus and infection were the most frequent complication being reported. 

 This study shows that early management of MGSWs with local flaps results in better psychosocial profile, aesthetics, reduced hospital stay and faster  functional rehabilitation.

Coverage of traumatic soft-tissue defects in the lower limb is a common procedure.

The purpose of this prospective case series study was explore the capacity of the perforator-based sural flap in reconstruction surgery of patients with high velocity gunshot wounds in the distal third of the leg and heel pad of the foot.

A prospective case series study was undertaken to assess the sural fasciocutaneous flap carried out in our hospital, from 2010 to 2011. This case series study comprised eight patients, seven men and one woman with an average age of 35 years (19-55) and with a mean follow-up duration of 13 months (6-24 months). All patients had a history of a gunshot wound in distal part of the leg and heel pad of the foot with large soft-tissue defects; treatment was done using the reverse sural flap..

We performed reverse sural flaps in eight gunshot patients, to cover the defects of the lower leg and foot. Surgical site infection observed in one patient (12.5%) was treated successfully with antibiotic therapy. The reverse sural flap provided a satisfactory coverage for gunshot defects in all the patients.

Reverse sural flap is a useful and versatile reconstructive method in patients with gunshot wounds of the lower leg and foot.