• Journal of Trauma and Injury
• /
• v.28 no.2
• /
• pp.71-74
• /
• 2015

Penetrating neck trauma involving spinal cord injury is relatively uncommon, but can be life-threatening. We report a case of 59-year-old female who presented with hypotension after stab injury self-inflicted with a scissor to her neck. Although Open removal of the scissor and control of bleeding were successfully done, penetration of spinal cord resulted in a neurologic impairment.

• Journal of Trauma and Injury
• /
• v.33 no.4
• /
• pp.269-274
• /
• 2020

Open pelvic fractures are rare, but pose challenges for trauma surgeons due to their high morbidity and mortality. Generally, early death results from uncontrolled exsanguination and late death is related to pelvic sepsis. Therefore, management of these injuries should prioritize hemostasis and contamination control starting in the initial phase of treatment. We report two cases of unstable open pelvic fractures with perineal wounds that were managed successfully.

• Journal of Trauma and Injury
• /
• v.32 no.2
• /
• pp.115-117
• /
• 2019

Although hemothorax and pneumothorax are common complications seen in rib fractures, focal extrapleural hematoma is quite rare. We report a 63-year-old female patient that developed large focal extrapleural hematoma after falling off a second floor veranda. The patient had sustained 3, 4, 5th costal cartilage rib fractures and a sternum fracture. She had developed suspected empyema with loculations with small amount of hemothorax. She underwent a planned early decortication/adhesiolysis by video assisted thoracoscopic surgery at the 12th post-trauma day due to failed drainage. Unexpectedly, she had no adhesions or any significant retained hematoma mimicking a mass, but was found with the focal extrapleural chest wall hematoma. She was discharged on postoperative 46th day for other reasons and is doing fine today.

• Journal of Trauma and Injury
• /
• v.29 no.4
• /
• pp.155-160
• /
• 2016

Purpose: Two years have passed since a level I trauma center was officially opened in the Gacheon Gil Hospital, South Korea. We analyzed 2014 and 2015 registered patient data from the Korean Trauma Data Base (KTDB) to identify trends in trauma patient care and factors that influence the quality of trauma care at the Gacheon Gil trauma center. Methods: Data was extracted from the KTDB included patient age, sex, systolic blood pressure at emergency room arrival, revised trauma score, injury severity score, trauma injury severity score, transfusion amount, and the cause of death was analyzed. Results: A total of 3269 trauma patients were admitted to our trauma center in 2014 and 3225 in 2015. Demographics and mechanism of injury were not significantly different between years. The severity of trauma injury was decreased in 2015 although the mortality rate was slightly increased. This requires further analysis. Conclusion: The aim of this study was to determine the general status and trends in trauma incidence and management outcomes for the Incheon area. We noted no significant changes in trauma status from 2014 to 2015. We need to collect and review trauma patient data over a long period in order to elucidate trauma incidence and management trends in the trauma field. Finally, studies using trauma patient data will indicate appropriate quality control factors for trauma care and help to improve the quality of trauma management.

• Journal of Trauma and Injury
• /
• v.36 no.3
• /
• pp.224-230
• /
• 2023

Purpose: Patients with penetrating injuries are at a high risk of mortality, and many of them require emergency surgery. Proper triage and transfer of the patient to the emergency department (ED), where immediate definitive treatment is available, is key to improving survival. This study aimed to evaluate the epidemiology and outcomes of patients with penetrating torso injuries in Incheon Metropolitan City. Methods: Data from trauma patients between 2014 and 2018 (5 years) were extracted from the National Emergency Department Information System. In this study, patients with penetrating injuries to the torso (chest and abdomen) were selected, while those with superficial injuries were excluded. Results: Of 66,285 patients with penetrating trauma, 752 with injuries to the torso were enrolled in this study. In the study population, 345 patients (45.9%) were admitted to the ward or intensive care unit (ICU), 20 (2.7%) were transferred to other hospitals, and 10 (1.3%) died in the ED. Among the admitted patients, 173 (50.1%) underwent nonoperative management and 172 (49.9%) underwent operative management. There were no deaths in the nonoperative management group, but 10 patients (5.8%) died after operative management. The transferred patients showed a significantly longer time from injury to ED arrival, percentage of ICU admissions, and mortality. There were also significant differences in the percentage of operative management, ICU admissions, ED stay time, and mortality between hospitals. Conclusions: Proper triage guidelines need to be implemented so that patients with torso penetrating trauma in Incheon can be transferred directly to the regional trauma center for definitive treatment.

• Journal of Trauma and Injury
• /
• v.29 no.2
• /
• pp.43-46
• /
• 2016

Traumatic diaphragmatic injury (TDI) occurs in 1% of patients of blunt abdominal trauma. Most TDIs involve the left diaphragm, however the authors experienced TDI accompanied by a liver laceration of the right diaphragm. When detected early, TDI can be easily treated, however serious complications can occur if not. When diaphragmatic injury is suspected due to clinical manifestation, comprehensive analysis of the patient data including radiologic findings is important.

• Journal of Trauma and Injury
• /
• v.28 no.4
• /
• pp.241-247
• /
• 2015

Purpose: To evaluate the influence of how the trauma care system is applied on the management of trauma patients. Methods: We divided the patients into a pre-trauma system group and a post-trauma system group according to the time when we began to apply the trauma care system in our institution. We compared the general characteristics, injury severity score, initial response time to the trauma patients, number of preventable deaths, and clinical outcomes between the two groups. Results: The numbers of patients in the pre-trauma system group and the post-trauma system group were 188 and 257, respectively. No differences in the patient's median ages, trauma scores (ISS, RTS, TRISS) and proportions of severe trauma patients (ISS>15) were observed between the two groups. The number and the proportion of patients who were admitted to our hospital were increased in the post-trauma system group. The time interval from trauma CP activation to emergency surgery or angio-embolization, and the patient's time spent in emergency room were shortened in the post-trauma system group. However, the lengths of the ICU stay and the hospital stay, and the number of in-hospital mortalities were not improved in the post-trauma system group. In severe trauma patients (ISS>15), there were no differences between the two groups in the number and the proportion of admitted patients, and the time interval from trauma CP activation to performing a diagnostic and therapeutic procedure was not shortened in the post-trauma system group. Conclusion: Application of the trauma care system has shortened the time between the initial response and patient management. However, this improvement was not enough to result in better clinical outcomes. More trauma physicians, multidisciplinary cooperation, and a well-organized trauma management process will be needed if the maximum efficacy of the trauma system is to be achieved.

• Journal of Trauma and Injury
• /
• v.28 no.1
• /
• pp.39-42
• /
• 2015

Lat. abdominal wall hematoma with active bleeding is very rare but need prompt bleeding control. We report successful treatment by angiographic embolization of superficial circumflex iliac artery rupture caused by blunt trauma. A 60-year-old woman presented painful, enlarging, lat. abdominal wall mass with ecchymosis caused by blunt abdominal trauma. Contrast leakage of superficial circumflex iliac a. within the lt. ext. oblique m. hematoma was confirmed by abdominal computed tomography. Angiographic embolization was performed successfully. Patient was discharged at 4th day after trauma without complication. Angiographic embolization is important treatment option of lat. abdominal wall hematoma with active bleeding replacing emergency surgery.

• Journal of Trauma and Injury
• /
• v.35 no.4
• /
• pp.261-267
• /
• 2022

Purpose: With the increasing number of polytrauma patients treated at high-level trauma centers, plastic surgery has entered the specialty of traumatology. Plastic surgeons specialize in the simultaneous surgical care of patients with facial or hand trauma and soft tissue injuries requiring microsurgery. The purpose of this study was to introduce the role of plastic surgery in a high-level trauma center. Methods: Between January 2020 and December 2020, 5,712 patients with traumatic injuries were admitted to the emergency department of a tertiary hospital. Of these 5,712 patients, 1,578 patients were hospitalized for surgical treatment and/or critical care. Among the 1,578 hospitalized trauma patients, 551 patients (35%) required at least one plastic surgery procedure. The patient variables included age, sex, etiology, the injured area, and injury characteristics. We also retrospectively investigated surgical data such as the duration of the operation, hospital stay, length of time from injury to surgery, and collaboration with other departments. Results: The most common injury referred to plastic surgery was facial trauma (41%), followed by hand trauma (36%), and soft tissue injuries requiring microsurgery in various parts of the body other than the hand (7%). The majority of facial and hand traumas were concomitant injuries. Sixteen percent of patients underwent collaborative surgical management for polytrauma involving both plastic surgery and another department. Conclusions: The role of plastic surgery in multidisciplinary teams at high-level trauma centers has become increasingly important. The results of this study may help in the development of multidisciplinary trauma team strategies and future workforce planning.

• Journal of Trauma and Injury
• /
• v.31 no.1
• /
• pp.29-33
• /
• 2018

Traumatic blunt aortic injury especially on proximal ascending aorta is a rare injury with a few reports. Generally emergency surgical management was performed. In this case, however, in multiple trauma with brain injury, emergency surgical management of aortic injury might result in unexpected secondary injury of the brain. Herein, we report a case of a 33-year-old man who was driving a truck was injured in a head-on collision. Evaluation revealed a pseudoaneurysm on his ascending aorta concomitant with epidural hemorrhage. He was treated by surgical management of his ascending aorta after 3 days from accident. There were no postoperative and neurologic complications and the patient was discharged after 18 days.