Friday, January 6, 2012

Surgery Is Not Always for Gunshot Wound


In crime programs on television, when people who had been stabbed or shot in the stomach, they usually arrive at the hospital who rushed into the operating room

In real life, though, that occur more frequently. Some patients may avoid the test of emergency abdominal surgery - even some who still has a bullet lodged in it - says Adil Haider, an associate professor of surgery, anesthesiology and critical care medicine at Johns Hopkins University School of Medicine and lead author of recently published study of non-selective calling operations management (SNOM) damage.

Surgery carries the risk of infection and other complications, and is not always necessary to determine whether there are internal injuries that require treatment. One of his co-author, Amy Rushing, assistant professor in the same department, said that CT is better to reduce the need for multiple testing operations.

The study, published in the British Journal of Surgery, which is used by the national trauma registry of the U.S., identified 12.707 patients with abdominal injuries and stab wounds in the abdomen gunshot 13.030 between 2002 and 2008.

SNOM has found it increasingly popular for the damage. This method is used in approximately 22% of patients and abdominal gunshot 34% of patients, stab wounds, and SNOM levels increased during the study period. Not surprisingly, the average hospital stay for patients with SNOM success is much shorter than the test operation.

However, the study should be viewed as a "warning" on the SNOM. This is due to the lack of nonsurgical treatment in approximately 21% of victims and 15% gunshot to stab the victim, which means that patients eventually required surgery after all. And the mortality rate for patients is higher than the patients who went SNOM operation. (The study notes that it is unclear whether patients who were dying was better, if you want a surgery right away.)

SNOM requires proper patient selection that requires attention to factors such as severity of injury, vital signs and the need for blood transfusion. The facility must have trained clinicians to monitor patients for signs that they are more seriously injured than originally thought, and should have at home and surgeons operating in space 24 / 7 surgical cases required, concluded study.

A comment by the study notes that because SNOM is limited to trauma centers and knowledge resources available, the failure rate is probably the best that can be achieved at this time, said Jurkovich Gregory, professor of surgery at the University of Washington.

Despite showing that the method can be practiced "in certain circumstances," SNOM "protection is not perfect, and certainly not for everyone," JURKOVICH writes.

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