Objectives: to evaluate the epidemiological profile, the surgical treatment and the postoperative results of patients with complex traumatic injuries to the lower limbs. Methods: we conducted a retrospective study of patients with traumatic complex injuries treated by the Plastic Surgery Service of a regional hospital in Brasília. We analyzed clinical-epidemiological data, type of surgical procedure and functional recovery of the limb after six months of treatment. Results: 119 patients were treated, with a mean age of 29 years, predominantly men (76.4%). Motorcycle accident was responsible for most of the injuries, in 37.8% of cases. The most frequent surgical treatment was skin grafting (62.1%), followed by the fasciocutaneous flap (21.9%), muscular flap (12.6%) and microsurgical flap (3.4%). Six months after completion of the surgical treatment, 35.3% of the patients needed crutches to move, characterizing a delay in limb functional recovery that, however, was significantly related to the presence of fractures, external fixation or bone exposure in the preoperative period. Conclusion: the profile of the patient with complex traumatic lower limb injury was a male, motorcycle accident victim, and grafting was the most used treatment. Orthopedic trauma with bone fracture, bone exposure and the presence of external fixator were significantly associated with a higher risk of limb functional impairment, requiring locomotion crutches after six months of treatment.
Objetivo: determinar as indicações e vantagens da transfusão sanguínea autóloga. Método: Revisão sistemática de estudos, que abordaram a autotransfusão sanguínea, publicados entre o período de 2015 a 2020. Resultados: A pesquisa gerou 8.696 resultados e destes, foram selecionados 2 artigos que preencheram os critérios de seleção pré-estabelecidos. Nos estudos, autotransfusão foi indicada em casos de anemia hemolítica imune induzida por drogas, pressão arterial e frequência cardíaca baixas (devido a perda sanguínea), antecipação de perda de sangue > 1 litro, necessidade de uma ou mais unidades de transfusão de sangue alogênicas no período pós-operatório, recusas religiosas, hemotórax traumático e choque hemorrágico seguido de cirurgia toracoscópica. As vantagens descritas foram: ausência de reações transfusionais, tratamento de vítimas que requerem sangue no ponto de lesão e redução da necessidade de doadores. Não foram observadas complicações relacionadas. Conclusão: Apesar das vantagens da transfusão autóloga, ainda há uma quantidade escassa de artigos publicados sobre o tema. Dessa forma, é visto necessário a realização de ensaios clínicos adicionais que comparem os dois métodos, para esclarecer elegibilidade das diversas perspectivas de aplicação clínica de cada método no cenário de trauma.
Bleeding of the main health problems is intraoperative in hospitals, mainly. Control of adequate oxygen is essential for tissue oxygen. Autologous blood transfusion is used as a strategy to reduce the possibility of negative effects of allo transfusion and in situations of lack of donated blood. The aim of the study is to determine the importance and advantages of intraoperative autologous transfusion through a systematic review of studies addressing autotransfusion, published between 2016 and Busca2021. In studies, autotransfusion was mainly indicated in critically ill patients with massive bleeding induced by chest trauma associated with hemorrhagic shock, requiring emergency blood transfusion, where it is not possible to wait for blood preparation or where blood is lacking. In addition, its use has been reported in orthopedic surgeries such as total hip and knee arthroplasty. As benefits of lack of resources: reduction of benefits treatment resources, reduction of the need for local finance resources. No related complications were observed. In conclusion, despite the various advantages of autologous transfusion, published articles on the subject are still scarce. Thus, it is necessary to carry out clinical trials that compare the two methods, for the eligibility of the different perspectives of clinical application of each method in the trauma scenario.
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