Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Trauma - Systemic
Abstract number: 25577
DIAGNOSIS AND TREATMENT IN CRUSHING TRAUMA
MIHAIL NAGEA 1 , OLIVERA LUPESCU 2 , CRTISTINA PATRU 3 , CORNELIA
VASILACHE 3
1
EMERGENCY HOSPITAL , BUCHAREST, BUCHAREST (ROMANIA),
2
UNIVERSITY OF MEDICINE AND PHARMACY, EMERGENCY HOSPITAL,
BUCHAREST, BUCHAREST (ROMANIA),
3
EMERGENCY HOSPITAL,
BUCHAREST, BUCHAREST (ROMANIA)
PURPOSE Complete diagnosis of trauma includes not only the injuries, but also the
mechanism, suggesting the trauma energy. The purpose of this study is to establish
a therapeutic protocol depending on clinical aspects .MATERIAL and METHOD- This
prospective study analyses 165 patients admitted in our hospital between
01.06.2004-01.01.2008 with a diagnosis including crushing. The main clinical
aspects of these casese were: crushing without fracture, fracture, open injury,
compartment syndrome (with or without fracture), acute peripheral ischaemia. The
authors describe the algorithm for diagnosis ( including laboratory findings and
complementary examinations) and treatment ( following MESS_Score) for these
cases. RESULTS In 78% of crushings of the shank compartment syndrome
appeared ( 82% of the cases with fracture and 64% of cases with crushing without
fracture).Fracture appeared in 75% of the cases, and open injuries only in 60% of the
cases. 40% of the crushings produced complex trauma (vascular or nervous injury),
acute peripheral ischaemia appeard after 25% of the crushings.CONCLUSIONS-The
crushing mechanism is associated with high energy trauma, which can produce
severe injuries, with different clinical aspects. Initial correct diagnosis, followed by
specific monitoring and treatment provides the favourabla outcome of the patient.
The recomended treatment is surgical- fasciotomy. The eficacy of the treatment is
reflected in decrease of fatal complications (renal failure, MSOF) and favorable local
outcome.
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