RESUMO
Utilization of CT scans in the work-up of trauma patients has led to increasing diagnosis of traumatic pseudoaneurysms (PSAs). While rare, PSAs have devastating consequences if ruptured. Evidence for the benefit of early detection of PSAs is lacking. The objective of this case series was to determine the incidence of solid organ PSAs after trauma. A retrospective chart review of patients with AAST grade 3-5 traumatic solid organ injuries was performed. 47 patients were identified with PSAs. PSAs were most common in the spleen. A CT finding of contrast blush or extravasation was found in 33 patients. 36 patients underwent embolization. 12 patients had an abdominal CTA prior to discharge. Re-admission was required for 3 patients. 1 patient presented with PSA rupture. During the study, there was no consistency in surveillance for PSAs. Future studies are needed to develop evidence-based practice guidelines for PSA surveillance in high risk populations.
Assuntos
Traumatismos Abdominais , Falso Aneurisma , Ferimentos não Penetrantes , Masculino , Humanos , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/epidemiologia , Falso Aneurisma/etiologia , Estudos Retrospectivos , Antígeno Prostático Específico , Ferimentos não Penetrantes/complicações , Ferimentos não Penetrantes/diagnóstico por imagem , Ferimentos não Penetrantes/terapia , Baço/lesões , Traumatismos Abdominais/complicações , Traumatismos Abdominais/diagnóstico por imagemRESUMO
Background and Aims: Minimally adherent silver dressings (SILVER MASD) are antimicrobial, nonirritating, provide a moist wound healing environment, and low cost. The purpose of this pilot, single-center, non-blinded randomized controlled trial was to quantify the outcomes of acute surgical wounds treated with MASD versus standard of care (SoC) dressings. Methods: Thirty-two patients with acute wounds were randomized 1:1 to be treated with MASD once weekly or SoC following surgical excision of skin and/or subcutaneous tissue between September 13, 2016 and November 28, 2017. The outcome variables included clinical infection, time to wound closure, and pain scores at dressing changes. Two independent, one-sided sample t-tests were performed to assess statistical significance. Results: There was no difference in wound healing between SILVER MASD and SoC. Dressing changes were less painful for wounds managed with MASD silver dressings. Conclusions: The results of this study suggest that MASD are not less effective in wound healing compared to SoC while also providing the benefit of decreased pain at dressing changes. Therefore, minimally adherent silver dressings can and should be considered a viable option in the management of acute surgical wounds.