Quality of life and clinical outcomes of operatively treated patients with flail chest injuries: A multicentre prospective cohort study

Hoepelman, Ruben J.; Minervini, Fabrizio; Beeres, Frank J. P.; Wageningen, Bas van; IJpma, Frank F. A.; Veelen, Nicole M. van; Lansink, Koen W.W.; Hoogendoorn, J. M.; Baal, Mark. C. P. van; Houwert, Roderick M.

doi:10.3389/fsurg.2023.1156489

Cited by 3 publications

(3 citation statements)

References 38 publications

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“…50 They so far published four relevant papers with a natural experiment as methodology and more studies are being conducted and soon to be published. 27,28,51,52 One study showed that with a natural experiment design on rib fixation there was no difference in outcome between nonoperative and operative treated patients. 27 The inclusion was finished one year earlier than predicted and took three years.…”

Section: Discussionmentioning

confidence: 99%

“…21 Multiple natural experiments in trauma surgery have been conducted reporting results matching the credibility of randomized controlled trials. [24][25][26][27][28] However, natural experiment design is a relatively new study method in surgical research. This is also the case in spinal trauma and it is currently unknown to what degree natural experiment designs are utilized and to what extent they provide credible evidence.…”

Section: Introductionmentioning

confidence: 99%

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Natural Experiments as a Study Method in Spinal Trauma Surgery: A Systematic Review

Stadhouder,

van Rossenberg,

Kik

et al. 2023

Global Spine Journal

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Study Design Systematic review. Objectives To determine if the natural experiment design is a useful research methodology concept in spinal trauma care, and to determine if this methodology can be a viable alternative when randomized controlled trials are either infeasible or unethical. Methods A Medline, Embase and Cochrane database search was performed between 2004 and 2023 for studies comparing different treatment modalities of spinal trauma. All observational studies with a natural experiment design comparing different treatment modalities of spinal trauma were included. Data extraction and quality assessment with the MINORS criteria was performed. Results Four studies with a natural experiment design regarding patients with traumatic spinal fractures were included. All studies were retrospective, one study collected follow-up data prospectively. Three studies compared different operative treatment modalities, whereas one study compared different antibiotic treatment strategies. Two studies compared preferred treatment modalities between expertise centers, one study between departments (neuro- and orthopedic surgery) and one amongst surgeons. For the included retrospective studies, MINORS scores (maximum score 18) were high ranging from 12-17 and with a mean (SD) of 14.6 (1.63). Conclusions Since 2004 only four studies using a natural experiment design have been conducted in spinal trauma. In the included studies, comparability of patient groups was high emphasizing the potential of natural experiments in spinal trauma research. Natural experiments design should be considered more frequently in future research in spinal trauma as they may help to address difficult clinical problems when RCT’s are infeasible or unethical.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Natural Experiments as a Study Method in Spinal Trauma Surgery: A Systematic Review

Stadhouder,

van Rossenberg,

Kik

et al. 2023

Global Spine Journal

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“…Severe pain can worsen breathing difficulties. Flail chest is the second most common cause of death from chest trauma after chest vascular injury ( 3 ). Open reduction and internal fixation (ORIF) of ribs is often used to resolve the instability of the chest wall in patients with flail chest ( 4 , 5 ).…”

Section: Introductionmentioning

confidence: 99%

3D-printed external fixation guide combined with video-assisted thoracoscopic surgery for the treatment of flail chest: a technical report and case series

Hu,

Sun,

Bao

et al. 2023

Front. Surg.

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BackgroundFlail chest is a common and serious traumatic condition in thoracic surgery. The treatment of flail chest often includes open reduction and internal fixation, which is relatively traumatic, complicated, and expensive. As three-dimensional (3D) printing technology is widely used in the clinical field, the application of 3D-printed products to chest trauma will become a new treatment option. To date, the use of 3D-printed external fixation guides for flail chests has not been reported. Thus, we aimed to assess the short-term efficacy of a new technology that treated flail chests with an individualized 3D-printed external fixation guide combined with video-assisted thoracoscopic surgery (VATS).Patients and methodsA retrospective analysis was performed on patients with flail chest treated with this new technique at our center from January 2020 to December 2022. The following parameters were included: operative time, thoracic tube extraction time, intensive care unit time, thoracic volume recovery rate, visual analog scale score 1 month postoperatively, and postoperative complication rate. All patients were followed up for at least 3 months.ResultsFive patients (mean age: 45.7 years) were enrolled; they successfully underwent surgery without chest wall deformity and quickly returned to daily life. The average number of rib fractures was 8.4; all patients had lung contusion, hemopneumothorax, and anomalous respiration. The abnormal breathing of all patients was completely corrected on postoperative day 1, and the chest wall was stable. One case experienced mild loosening of the 3D-printed guide postoperatively; however, the overall stability was not affected. The other four cases did not experience such loosening because we replaced the ordinary silk wire with a steel wire. All cases were discharged from the hospital 2 weeks postoperatively and returned to normal life 1 month after the removal of the 3D-printed guide on average. Only one case developed a superficial wound infection postoperatively, and no perioperative death occurred.ConclusionsThe 3D-printed external fixation guide combined with video-assisted thoracoscopic surgery is a novel technique in the treatment of flail chest and is safe, effective, feasible, and minimally invasive, with satisfactory clinical efficacy.

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Surgical versus non-surgical treatment of flail chest: a meta-analysis of randomized controlled trials

Ferreira,

Pasqualotto,

Viana

et al. 2023

Eur J Trauma Emerg Surg

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Quality of life and clinical outcomes of operatively treated patients with flail chest injuries: A multicentre prospective cohort study

Cited by 3 publications

References 38 publications

Natural Experiments as a Study Method in Spinal Trauma Surgery: A Systematic Review

Natural Experiments as a Study Method in Spinal Trauma Surgery: A Systematic Review

3D-printed external fixation guide combined with video-assisted thoracoscopic surgery for the treatment of flail chest: a technical report and case series

Surgical versus non-surgical treatment of flail chest: a meta-analysis of randomized controlled trials

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