This book provides a practical guide to decision making within the realm of trauma surgery. Each chapter covers the ideal approach, rather than customary care, for the treatment of the chosen difficult decision or controversy. A broad range of topics are covered with particular attention given to resuscitation, wound management, thoracic and abdominal trauma, antimicrobial management, transplant considerations, vascular trauma, traumatic brain injury, pediatric trauma and ethics.
Difficult Decisions in Trauma Surgery aims to help improve the treatment of trauma patients and is relevant to surgical trainees and practicing surgeons, and as well as medical professionals working within trauma medicine.
Part I: Resuscitation.- Difficult Decisions in Trauma Is ABC the Right
Mantra?.- What is the Clinical Impact of Whole Blood as Compared to Component
Therapy in Civilian Trauma?.- Does Helicopter Transport to Level I Trauma
Centers Improve Mortality.- Futility of Care in Hemorrhagic Shock: When
Prolonging the Massive Transfusion Protocol is of No Benefit.- In the
exsanguinating trauma patient does REBOA, compared with resuscitative
thoracotomy (RT), result in lower complications, morbidity, and mortality?.-
Part II: Wound Management.- In Patients with Traumatic Extremity Wounds is
Negative Pressure Wound Therapy Superior as Compared to Standard Dressing
Changes?.- Enterocutaneous Fistula Management in Trauma.- Part III:
Antimicrobial Management.- Does prophylactic antibiotics for emergent tube
thoracostomy decrease rates of infection?.- Antibiotics Prophylaxis after
Penetrating Colon Injuries.- Antibiotic Regimen in Treating Complicated
Intra-abdominal Infections.- Is Vaccine Prophylaxis Necessary for Patients
Undergoing Splenic Embolization?.- Part IV: Trauma Imaging.- The Trauma
Pan-Scan: Who Benefits from Immediate Whole-Body Imaging?.- Non-Selective
Arterial Embolization for Pelvic Fractures.- Clinical clearance of the
cervical spine in the presence of a distracting injury.- MRI Clearance for
the Cervical Spine.- Part V: Traumatic Brain Injury.- Difficult Decisions in
Surgery: An Evidence-Based Approach ECMO safety in the setting of traumatic
brain injury.- Can Abdominal Decompression Improve Refractory Intracranial
Hypertension?.- Is there an Optimal Screening tool to Best Diagnose and Treat
Blunt Cerebrovascular Injury (BCVI)?.- Part VI: Abdominal Trauma.- Does
specific sequencing of operative interventions in thoracoabdominal trauma
improve outcomes?.- Selective Nonoperative Management for Abdominal Gunshot
Wounds.- What is the optimal management of traumatic duodenal injury?.-
Timing of Ostomy Reversal in Trauma and Acute Care Surgery.- Part VII:
Thoracic Trauma.- Resuscitative Thoracotomy.- Extracorporeal Membrane
Oxygenation for Patients with Traumatic Injury and Respiratory Failure.- Is
There a Gold Standard for Screening Blunt Cardiac Injury?.- Optimal Chest
Tube Size for Hemothorax Evacuation.- Should Intrapleural Fibrinolytic
Therapy be a First-Line Therapy for Post-Traumatic Retained Hemothoraces?.-
Rib Plating in the Acute Trauma Setting.- Does Thoracic Irrigation at the
Time of Chest Tube Placement Decrease the Incidence of a Retained
Hemothorax?.- The Timing of VATS for a Retained Hemothorax.- Part VIII:
Ethics.- Donation after Cardiac Death in the Emergency Department.-
Resuscitative Thoracotomy for Organ Donation.- Resilience training for the
trauma surgeon.- Youth Violence Prevention: Violence Recovery
Programs.- Part IX: Peripheral Vascular Trauma.- Are Temporary Vascular
Shunts (TVS) Effective Damage Control Adjuncts for Limb Salvage?.- Difficult
Decisions in Surgery: An Evidence-Based Approach Limb salvage for the mangled
extremity.- Part X: Pediatric Trauma.- The use of FAST in the Pediatric
Trauma Setting.- Selective Nonoperative Management of Children with
Penetrating Abdominal Trauma.- Are outcomes equivalent for injured children
treated at pediatric or adult trauma centers, and what are the implications
with respect to the design of optimal trauma systems?.
Kenneth L. Wilson, MD, FACS, COL, MC USAR is a Professor of Surgery at the University of Chicago. He serves as the Trauma Medical Director at the University of Chicago Medicine Trauma Center.
Selwyn O. Rogers Jr., MD, MPH, FACS, Professor of Surgery is the founding director of the University of Chicago Medicine Trauma Center. As Executive Vice President for Community Health Engagement, Dr. Rogers works with faculty across the University of Chicago as well as members of the community to develop a multidisciplinary approach to trauma care and health disparities.
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