Topic Editors

Department of Experimental and Clinical Medicine, University of Florence, 50121 Firenze, FI, Italy
1. General Surgery and Trauma Team, ASST Niguarda, Milano, Piazza Ospedale Maggiore 3, 20162 Milan, Italy
2. Department of Medical-Surgical Pathophysiology and Transplantation, University of Milan, Festa del Perdono 7, 20122 Milan, Italy
Dr. Shailvi Gupta
R Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, MD 20742, USA

Advances in Trauma Pathophysiology

Abstract submission deadline
closed (22 November 2021)
Manuscript submission deadline
closed (22 February 2022)
Viewed by
11255

Topic Information

Dear Colleagues,

Trauma is a public health epidemic. It is the leading cause of death in people aged 1 to 44 and is the sixth leading cause of death worldwide. It is estimated that one person in the world dies every five seconds as a result of traumatic injury, accounting for more than 5.8 million victims a year or 10% of the world’s deaths – 32% more than malaria, tuberculosis and HIV/AIDS combined. Its incidence is growing worldwide, particularly in low- and middle-income areas. In this issue we want to offer a broad excursus on trauma, taking into account the spread of trauma education in the population, the training of specialists in trauma care, the current state of trauma researches with particular attention to new developments and results in knowledge of the pathophysiology of trauma and the new achievements in treatment.

The trauma system of a given region or country represents a local solution to a complex organizational problem, involving coordination of resources and services provided by many players, and is largely dependent on tradition rather than outcome driven data. Certain countries are more developed in delivering trauma care, as the burden of injury is often greater in low-and-middle income countries. These countries may have a lack of human and material resources, the absence of organized trauma systems and inadequate injury surveillance. While many improvements have been made in trauma care globally this past century, the work has yet to be completed. Discussing the advances in trauma pathology, research, training and the dissemination of trauma education is crucial to help build up improved trauma care globally. With technology and globalization, our world is getting smaller. Helping each other move forward together is key to success for improving trauma care globally.

Dr. Desire' Pantalone
Dr. Stefania Cimbanassi
Dr. Shailvi Gupta
Topic Editors

Article processing charge will be waived for all accepted manuscripts in Surgeries before 22 February 2022.

Keywords

  • physiological response to trauma
  • training in trauma treatment
  • simulation techniques in trauma training
  • the critically ill patient in trauma setting
  • research in hemorrhagic shock in trauma: the resuscitative endovascular balloon for the occlusion of the aorta (REBOA)
  • infections and sepsis, MOF and MODS in trauma patients
  • negative pressure wound healing therapy (NEWT)
  • the complex trauma of the pelvis
  • the return to normal life after trauma
  • spreading the culture of trauma and its treatment to the population
  • the “stop the bleed campaign”
  • the role of the immune innate system and DAMPs in trauma
  • the frail traumatized patient: the elderly, the pregnant woman, the child
  • acute respiratory failure in trauma (thoracic trauma and non-thoracic trauma)
  • the role of endothelial cells in trauma and other diseases
  • the role of mitochondria and mitochondrial DNA for therapy in trauma and other diseases
  • new concepts related to the inflammatory response present in trauma, burns and other diseases (IBD for example)
  • researches on the septic patient

Participating Journals

Journal Name Impact Factor CiteScore Launched Year First Decision (median) APC
Life
life
3.2 2.7 2011 17.5 Days CHF 2600
International Journal of Environmental Research and Public Health
ijerph
- 5.4 2004 29.6 Days CHF 2500
Surgeries
surgeries
- - 2020 24.9 Days CHF 1200

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Published Papers (5 papers)

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15 pages, 590 KiB  
Review
Surgery in the Next Space Missions
by Desiree Pantalone
Life 2023, 13(7), 1477; https://0-doi-org.brum.beds.ac.uk/10.3390/life13071477 - 29 Jun 2023
Viewed by 2060
Abstract
In the coming years, missions to the Moon and Mars shall be the new goals of space flight. The complexity of these missions due to the great distance from Earth and the unforeseen obstacles to settle on another planet have given rise to [...] Read more.
In the coming years, missions to the Moon and Mars shall be the new goals of space flight. The complexity of these missions due to the great distance from Earth and the unforeseen obstacles to settle on another planet have given rise to great concerns for crew health and survival. The need for advanced crew autonomy and a different approach to surgical emergency require new protocols and devices to help future crew medical officers and other crew members in a task of unprecedented difficulty. Hence, the increasing variety of schedules, devices, and protocols being developed. A serious health problem, such as an emerging surgical disease or severe trauma, can jeopardize the mission and survival of the entire crew. Many other difficulties are present in deep-space missions or settlements on other planets, such as communication and supply, also medical, delays, and shortage, and the presence of radiation. Progress in advanced technologies as well as the evolution of robotic surgery and the use of artificial intelligence are other topics of this review. In this particular area of research, even if we are still very far from an “intelligent robot”, this evolution must be evaluated in the light of legislative and ethical considerations. This topic was presented at the annual meeting of the American College of Surgeons—Italy Chapter in 2021. Full article
(This article belongs to the Topic Advances in Trauma Pathophysiology)
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9 pages, 1503 KiB  
Article
Radiological and Functional Assessment of Treatment Outcomes in Patients after Open Reduction with Internal Fixation (ORIF) of Acetabular Fractures
by Emilia Dadura, Aleksandra Truszczyńska-Baszak and Dariusz Szydłowski
Int. J. Environ. Res. Public Health 2022, 19(3), 1277; https://doi.org/10.3390/ijerph19031277 - 24 Jan 2022
Viewed by 2774
Abstract
(1) Fracture of the pelvis usually happens in young men and results from high-energy trauma. It generates high social and economic costs and results in further health problems. It is therefore important to assess long-term treatment results. (2) The study (NCT04902209) involved 31 [...] Read more.
(1) Fracture of the pelvis usually happens in young men and results from high-energy trauma. It generates high social and economic costs and results in further health problems. It is therefore important to assess long-term treatment results. (2) The study (NCT04902209) involved 31 patients (mean age 43.6 ± 14.8 years). We conducted fixation assessment on the basis of radiographs and CT scans and functional assessment based on functional scales. (3) We observed more degenerative changes in the less precise reconstruction of the acetabulum (p = 0.075). We did not find statistically significant relationships between the area of surgical approach, the gravity of fracture, and the development of degenerative changes. We did not find statistically significant relationships between patients’ functional states and the type of surgical approach or the complexity of the fracture. We found a positive correlation between the time of surgical treatment and patients’ functional state (p = 0.04). Patients whose joint surfaces were reconstructed anatomically had significantly higher scores in functional scales (HHS p = 0.05, Merle p = 0.03). (4) Patients after surgical fixation of the acetabulum have low functional abilities. The quality of reconstruction of the loaded surface as well as the length of time post-surgery seems to be essential for the patients’ functional state. Full article
(This article belongs to the Topic Advances in Trauma Pathophysiology)
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14 pages, 1314 KiB  
Article
Therapeutic and Preventive Efficacy of an Intervention on Workers in a Back School
by Alberto Benito Rodríguez, Hugo Guillermo Ternavasio-de la Vega, José Ángel Santos Sánchez, Helena Iglesias de Sena, Miguel Marcos, Antonio Javier Chamorro and José Antonio Mirón-Canelo
Int. J. Environ. Res. Public Health 2022, 19(2), 1000; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19021000 - 17 Jan 2022
Cited by 3 | Viewed by 1800
Abstract
Back pain and its ailments are the main cause of absenteeism and sick leave. Furthermore, the cause of pain and disability in a large number of workers is unknown, and treatments are not effective in controlling it. For this reason, the Back Schools [...] Read more.
Back pain and its ailments are the main cause of absenteeism and sick leave. Furthermore, the cause of pain and disability in a large number of workers is unknown, and treatments are not effective in controlling it. For this reason, the Back Schools (BSs) provide theoretical and practical training to workers so that they can acquire knowledge and skills that will allow them to adequately manage their back problems, enabling them to recover their autonomy and prevent relapses. The aim of the study is to analyse the efficacy of a BS by means of the evaluation of pain and disability scales in workers in different sectors and in construction. The most important clinical benefits obtained after the intervention of a BS are the reduction of pain and disability. Statistically significant and clinically relevant results have been observed between the initial assessment and the 6-month review. BS has been shown to be effective in reducing low back and neck pain and disability during the first 6 months of follow-up. Construction workers have pain and disability rates at the overall mean and with improvements between the initial assessment and the 6-month review. Their rates of improvement are clinically more relevant than for the overall population analysed. Full article
(This article belongs to the Topic Advances in Trauma Pathophysiology)
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10 pages, 779 KiB  
Article
High-Grade Limbs Open Fractures: Time to Find Milestones in the Emergency Setting
by Michele Altomare, Stefano Granieri, Stefano Piero Bernardo Cioffi, Andrea Spota, Silvia Azisa Basilicò, Osvaldo Chiara and Stefania Cimbanassi
Life 2021, 11(11), 1226; https://0-doi-org.brum.beds.ac.uk/10.3390/life11111226 - 12 Nov 2021
Cited by 2 | Viewed by 1564
Abstract
(1) Background: The Gustilo–Anderson (G/A) grading system is a universally accepted tool used to classify high-grade limb open fractures. The purpose of this study is to find early independent predictors of amputation in emergency settings. (2) Methods: A retrospective analysis involving patients treated [...] Read more.
(1) Background: The Gustilo–Anderson (G/A) grading system is a universally accepted tool used to classify high-grade limb open fractures. The purpose of this study is to find early independent predictors of amputation in emergency settings. (2) Methods: A retrospective analysis involving patients treated at our center between 2010 and 2016 was conducted. Patients with at least one G/A grade III fracture or post-traumatic amputation were included. Three groups were identified: G/A IIIA (A group), G/A IIIB-C (BC group), and Amputation group (AMP group). Each group was further divided into two subgroups considering timing of coverage (early vs. delayed). Univariate and multivariate logistic regression models were developed to identify independent predictors of the limb’s outcome. (3) Results: One-hundred-six patients with G/A III A-B-C fractures or amputation of the affected limb were selected from the Niguarda Hospital Trauma Registry. The patients were divided into the A group (26), BC group (66), and AMP group (14). The rate of infectious complications following early or delayed coverage was evaluated: A group, 9.1% vs. 66.7% (p > 0.05); BC group, 32% vs. 63.6% (p = 0.03); and AMP group, 22% vs. 18.5% (p > 0.05). After further recategorization, the BC subgroups were analyzed: multivariate logistic regression model identified systolic blood pressure (SBP) <90 mmHg (p = 0.03) and Mangled Extremity Severity Score MESS ≥ 7 (p = 0.001) were determined to be independent predictors of limb amputation. (4) Conclusion: MESS and SBP serve as predictors of amputation. Based on the results, we propose a new management algorithm for mangled extremities. Early coverage is related to lower rates of infectious complications. Referral to high-volume centers with specific expertise is mandatory to guarantee the best results. Full article
(This article belongs to the Topic Advances in Trauma Pathophysiology)
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16 pages, 249 KiB  
Article
Predictive Factors of Ventilatory Support in Chest Trauma
by Silvia Fattori, Elisa Reitano, Osvaldo Chiara and Stefania Cimbanassi
Life 2021, 11(11), 1154; https://0-doi-org.brum.beds.ac.uk/10.3390/life11111154 - 29 Oct 2021
Cited by 2 | Viewed by 1522
Abstract
This study aims to define possible predictors of the need of invasive and non-invasive ventilatory support, in addition to predictors of mortality in patients with severe thoracic trauma. Data from 832 patients admitted to our trauma center were collected from 2010 to 2017 [...] Read more.
This study aims to define possible predictors of the need of invasive and non-invasive ventilatory support, in addition to predictors of mortality in patients with severe thoracic trauma. Data from 832 patients admitted to our trauma center were collected from 2010 to 2017 and retrospectively analyzed. Demographic data, type of respiratory assistance, chest injuries, trauma scores and outcome were considered. Univariate analysis was performed, and binary logistic regression was applied to significant data. The injury severity score (ISS) and the revised trauma score (RTS) were both found to be predictive factors for invasive ventilation. Multivariate analysis of the anatomical injuries revealed that the association of high-severity thoracic injuries with trauma in other districts is an indicator of the need for orotracheal intubation. From the analysis of physiological parameters, values of systolic blood pressure, lactate, and Glasgow coma scale (GCS) score indicate the need for invasive ventilatory support. Predictive factors for non-invasive ventilation include: RTS, ISS, number of rib fractures and presence of hemothorax. Risk factors for death were: age over 65, the presence of bilateral rib fractures, pulmonary contusion, hemothorax and associated head trauma. In conclusion, the need for invasive ventilatory support in thoracic trauma is associated to the patient’s systemic severity. Non-invasive ventilation is a supportive treatment indicated in physiologically stable patients regardless of the severity of thoracic injury. Full article
(This article belongs to the Topic Advances in Trauma Pathophysiology)
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