Introduction. Traumatic brain injuries (TBI) are a real social problem, with an upward trend worldwide. TBI is the leading cause of death and disability, especially among young men. Each year in Europe, and also in Poland, 243 per 100,000 individuals suffer from TBI. Assessing prognosis after traumatic brain injury is very important in order to help clinicians to make a decision about the implementation of specific methods of treatment, and to make communication with the patient and the patient's family easier. Objective. The objective of this review was to present prognostic factors, to assess outcomes within a short time after a moderate to severe traumatic brain injury, as well as to predict functional outcome. The most important independent variables were: age, Glasgow Coma Scale (GCS) motor score, pupil response, Marshall CT classification and traumatic subarachnoid haemorrhage. Other important prognostic factors included hypotension, hypoxia, glucose, coagulopathy, haemoglobin and category of CT characteristic, such as midline shift, mass lesion, basal cistern. Conclusions. Gender and intraventricular haemorrhage did not have predictive value. This subject needs much more research in the area of new prognostic factors which would be better associated with outcome after traumatic brain injury.

Reports of trauma caused by a horse kick in the abdomen are rare in the literature. This article presents 4 patients with injuries sustained this way. In all cases, injuries were sustained as a result of a sudden act of aggression while tending to the horse. In all the patients, the trauma consisted in severe injuries of abdominal organs, successfully managed by means of damage control procedures. Caution should be exercised during contact with horses, even when the care taker is familiar with the animal. This is particularly important in the case of individuals who are in contact with horses as part of their professional activities, such as horse breeders or veterinarians. Abdominal injuries resulting from horse kicks are generally very severe and should be managed by means of damage control.

A 59-year-old farmer was admitted to the Department of Trauma Surgery because of pain associated with the presence of a tumour on the side of the right thigh. The patient stated that his biggest problem was great difficulty in moving and handling agricultural machinery due to the aforementioned lesion. On physical examination, the patient presented with numerous cutaneous and subcutaneous neurofibromas, as well as one large plexiform neurofibroma. Diagnosis of Neurofibromatosis type 1 was established, based on National Institutes of Health diagnostic criteria. Moreover, molecular genetic testing found known pathogenic mutation p.Arg1769* in one of the alleles of NF1 gene (heterozygote), typical for Recklinghausen disease. The big plexiform neurofibroma in the patient was not operated on because of lung cancer.

Kulesza T, Mitrut T, Jojczuk M, Jahołkowski L, Nodalski A, Prystupa A. Treatment of lower limb trophic ulcers using hyperbaric oxygenation. J Pre-Clin Clin Res. 2014; 8(1): 44-47. AbstractLower limb venous ulcers affect approximately 1-1.3% of the population and constitute the most dangerous and distressing complication related to chronic venous insufficiency. Although the issue of trophic ulcer pathogenesis remains unclear, it is beyond doubt that adequate oxygen delivery to the tissues is the key factor in wound healing. Recent technological advances allow the use of hyperbaric oxygenation in patients with hard-to-heal wounds.Objective. The aim of this study is to present own results regarding the use of hyperbaric oxygenation in a group of 37 patients with lower limb trophic ulcers of vascular etiology, who were treated in the Clinic of Trauma Surgery and Emergency Medicine in Lublin. Material and methods. The study involved 37 patients, 22 women and 15 men, aged 42-84 years, treated in the Clinic of Trauma Surgery and Emergency Medicine in Lublin in 2011-2012. The group treated in the Clinic included 30 patients with venous ulcers (the largest group) as well as 3 patients with arterial ulcers and 4 patients with mixed arterial/venous ulcers. Patients were referred for further treatment in the Hyperbaric Centre of the District Hospital in Łęczna. The treatment included 20-30 compression sessions at a pressure of 2.5 ATA 1.6 kg/cm in a HiperTech Zyron 12 Multiplace chamber. A single session lasted 90 minutes. Results. Hyperbaric chamber treatment resulted in complete wound healing in 22 patients (more than 59%). Partial wound healing (half of the surface area) was achieved in 13 patients (35%). Lack of wound healing was observed in 2 patients (5%) with arterial and mixed ulcers.

The case is presented of a rare case of scalping foot injury of the degloving type, treated at the Clinic of Traumatology and Emergency Medicine at the Medical University in Lublin, Poland. The successful treatment used the simplest reconstructive technique involving the utilization of an intermediate thickness skin graft, which was taken from the detached skin of the feet. This technique should be taken into consideration in this era of using new and sophisticated methods of treating physical defects.