- Email: [email protected]
Re: Incidental Findings on Whole-body Computed Tomography. Injury 2016;47(March (3)): 691–694.
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Letters to the Editor / Injury, Int. J. Care Injured 47 (2016) 1871–1873
References [1] Jim’enez-Rodr’iguez DRM, Ciuro FP, Cruzado VDM, Cortes MF, Bernal FL, Padillo J. A new technique to close open abdomen using negative pressure therapy and elastic gums. Injury 2016;47(8):1871–2. [2] Candage R, Jones K, Luchette FA, Sinacore JM, Vandevender D, Reed RL. Use of human acellular dermal matrix for hernia repair: friend or foe? Surgery 2008;144(4):703–11. [3] Rasilainen SK, Mentula PJ, Leppäniemi AK. Vacuum and mesh-mediated fascial traction for primary closure of the open abdomen in critically ill surgical patients. Br J Surg 2012;99(12):1725–32. [4] Eltayeb AA, Ibrahim IA, Mohamed MB. The use of PROCEED mesh in ventral hernias: a pilot study on 22 cases. Afr J Paediatr Surg 2013;10:217–21. [5] Bruhin A, Ferreira F, Chariker M, Smith J, Runkel N. Systematic review and evidence based recommendations for the use of negative pressure wound therapy in the open abdomen. Int J Surg 2014;12(10):1105–14. [6] Nandhagopal V, Chittoria RK, Mohapatra DP, Thiruvoth FM, Sivakumar DK, Ashokan A. External tissue expansion for difficult wounds using a simple cost effective technique. J Cutan Aesthet Surg 2015;8:50–3.
B.S. Bibilash* Department of Plastic and Reconstructive Surgery, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, PIN 605008, India Asokan Karthika Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, PIN 605008, India M.T. Friji Ravi Kumar Chittoria Department of Plastic and Reconstructive Surgery, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, PIN 605008, India * Corresponding author. E-mail address: [email protected] (B. Bibilash). Received 9 May 2016 Accepted 7 May 2016 http://dx.doi.org/10.1016/j.injury.2016.05.008
Letter to the Editor Re: Incidental Findings on Whole-body Computed Tomography. Injury 2016;47(March (3)): 691–694.
We have also recently reviewed the incidence of incidental findings on TCT in a 6 month interval and found 67% of all patients some form of incidental finding ranging from benign finding of no significance to serious clinical findings requiring further investigation and/or treatment. 26% of patients >65 years of age had a previously unknown clinically significant incidental finding requiring further investigation. Considering the incidence of comorbidity in this patient group this finding is perhaps not surprising. A more concerning aspect of our review was that follow up or communication with the patient or primary care provider was not documented in a significant number of patients, 41%. These findings reflect the findings of Sierink et al. [3] in their review. This change in trauma demographic has challenged the preconceptions of many units as to the nature of major trauma and it may be that these elderly patients are being treated by alternate pathways in some centres, but we must keep in mind that documentation and appropriate follow up pathways must be improved to ensure high quality care for patients with previously unknown significant clinical findings Conflict of interest None. References [1] Seah MKT, Murphy CG, McDonald S, Carrothers A. Incidental findings on wholebody trauma computed tomography: experience at a major trauma centre. Injury 2016;47(March (3)):691–4. [2] Kehoe A, Smith JE, Edwards A, Yates D, Lecky F. The changing face of major trauma in the UK. Emerg Med J 2015;32:911–5. [3] Sierink JC, Saltzherr TP, Russchen MJAM, de Castro SMM, Beenen LFM, Schep NML, et al. Incidental findings on total-body CT scans in trauma patients. Injury 2014;45(May (5)):840–4.
John V. Taylor* Department of General surgery, University Hospital Aintree, Longmoor Lane, Liverpool L9 7AL, UK Sumita Chawla Department of Radiology, University Hospital Aintree, Longmoor Lane, Liverpool, L9 7AL, UK Emma Merrick Department of General surgery, University Hospital Aintree, Longmoor Lane, Liverpool, L9 7AL, UK * Corresponding author. E-mail address: [email protected] (J. Taylor). Received 9 May 2016 Accepted 7 May 2016
We read with interest the paper by Seah et al. [1] regarding the frequency of incidental findings following whole body trauma CT scanning (TCT) and broadly agree with their conclusions, however we feel that their results may well underplay the issue. The population that they have reviewed appears not to reflect the current major trauma population in the United Kingdom. In their review, the mean age of trauma patient was found to be 38.2 years and the predominant mechanism of injury was motor vehicle collision. Kehoe et al. [2] has recently reported the change in demographics of the UK trauma population using the national Trauma audit and Research Network (TARN) database and found that the current mean age of patients suffering major trauma (defined as an Injury severity Score >15) had risen to 53.8 years with 27.1% of patients >75 years. The commonest mechanism was found to be fall from low height (<2 m). These findings broadly mirror our own experience.
http://dx.doi.org/10.1016/j.injury.2016.05.045
Letter to the Editor Letter to editor based on article ‘An evaluation of the functional and radiological results of percutaneous vertebroplasty versus conservative treatment for acute symptomatic osteoporotic spinal fractures’
We read the article on evaluation of the functional and radiological results of percutaneous vertebroplasty (PV) versus
Letters to the Editor / Injury, Int. J. Care Injured 47 (2016) 1871–1873
References [1] Jim’enez-Rodr’iguez DRM, Ciuro FP, Cruzado VDM, Cortes MF, Bernal FL, Padillo J. A new technique to close open abdomen using negative pressure therapy and elastic gums. Injury 2016;47(8):1871–2. [2] Candage R, Jones K, Luchette FA, Sinacore JM, Vandevender D, Reed RL. Use of human acellular dermal matrix for hernia repair: friend or foe? Surgery 2008;144(4):703–11. [3] Rasilainen SK, Mentula PJ, Leppäniemi AK. Vacuum and mesh-mediated fascial traction for primary closure of the open abdomen in critically ill surgical patients. Br J Surg 2012;99(12):1725–32. [4] Eltayeb AA, Ibrahim IA, Mohamed MB. The use of PROCEED mesh in ventral hernias: a pilot study on 22 cases. Afr J Paediatr Surg 2013;10:217–21. [5] Bruhin A, Ferreira F, Chariker M, Smith J, Runkel N. Systematic review and evidence based recommendations for the use of negative pressure wound therapy in the open abdomen. Int J Surg 2014;12(10):1105–14. [6] Nandhagopal V, Chittoria RK, Mohapatra DP, Thiruvoth FM, Sivakumar DK, Ashokan A. External tissue expansion for difficult wounds using a simple cost effective technique. J Cutan Aesthet Surg 2015;8:50–3.
B.S. Bibilash* Department of Plastic and Reconstructive Surgery, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, PIN 605008, India Asokan Karthika Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, PIN 605008, India M.T. Friji Ravi Kumar Chittoria Department of Plastic and Reconstructive Surgery, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, PIN 605008, India * Corresponding author. E-mail address: [email protected] (B. Bibilash). Received 9 May 2016 Accepted 7 May 2016 http://dx.doi.org/10.1016/j.injury.2016.05.008
Letter to the Editor Re: Incidental Findings on Whole-body Computed Tomography. Injury 2016;47(March (3)): 691–694.
We have also recently reviewed the incidence of incidental findings on TCT in a 6 month interval and found 67% of all patients some form of incidental finding ranging from benign finding of no significance to serious clinical findings requiring further investigation and/or treatment. 26% of patients >65 years of age had a previously unknown clinically significant incidental finding requiring further investigation. Considering the incidence of comorbidity in this patient group this finding is perhaps not surprising. A more concerning aspect of our review was that follow up or communication with the patient or primary care provider was not documented in a significant number of patients, 41%. These findings reflect the findings of Sierink et al. [3] in their review. This change in trauma demographic has challenged the preconceptions of many units as to the nature of major trauma and it may be that these elderly patients are being treated by alternate pathways in some centres, but we must keep in mind that documentation and appropriate follow up pathways must be improved to ensure high quality care for patients with previously unknown significant clinical findings Conflict of interest None. References [1] Seah MKT, Murphy CG, McDonald S, Carrothers A. Incidental findings on wholebody trauma computed tomography: experience at a major trauma centre. Injury 2016;47(March (3)):691–4. [2] Kehoe A, Smith JE, Edwards A, Yates D, Lecky F. The changing face of major trauma in the UK. Emerg Med J 2015;32:911–5. [3] Sierink JC, Saltzherr TP, Russchen MJAM, de Castro SMM, Beenen LFM, Schep NML, et al. Incidental findings on total-body CT scans in trauma patients. Injury 2014;45(May (5)):840–4.
John V. Taylor* Department of General surgery, University Hospital Aintree, Longmoor Lane, Liverpool L9 7AL, UK Sumita Chawla Department of Radiology, University Hospital Aintree, Longmoor Lane, Liverpool, L9 7AL, UK Emma Merrick Department of General surgery, University Hospital Aintree, Longmoor Lane, Liverpool, L9 7AL, UK * Corresponding author. E-mail address: [email protected] (J. Taylor). Received 9 May 2016 Accepted 7 May 2016
We read with interest the paper by Seah et al. [1] regarding the frequency of incidental findings following whole body trauma CT scanning (TCT) and broadly agree with their conclusions, however we feel that their results may well underplay the issue. The population that they have reviewed appears not to reflect the current major trauma population in the United Kingdom. In their review, the mean age of trauma patient was found to be 38.2 years and the predominant mechanism of injury was motor vehicle collision. Kehoe et al. [2] has recently reported the change in demographics of the UK trauma population using the national Trauma audit and Research Network (TARN) database and found that the current mean age of patients suffering major trauma (defined as an Injury severity Score >15) had risen to 53.8 years with 27.1% of patients >75 years. The commonest mechanism was found to be fall from low height (<2 m). These findings broadly mirror our own experience.
http://dx.doi.org/10.1016/j.injury.2016.05.045
Letter to the Editor Letter to editor based on article ‘An evaluation of the functional and radiological results of percutaneous vertebroplasty versus conservative treatment for acute symptomatic osteoporotic spinal fractures’
We read the article on evaluation of the functional and radiological results of percutaneous vertebroplasty (PV) versus