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Medicina
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Current Therapies for Trauma and Surgical Critical Care
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Current Therapies for Trauma and Surgical Critical Care

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Surgery".

Deadline for manuscript submissions: 15 July 2025 | Viewed by 6873

Special Issue Editors

Dr. Yuko Ono

E-Mail Website
Guest Editor
Department of Disaster and Emergency Medicine, Graduate School of Medicine, Kobe University, Kobe City 650-0017, Japan
Interests: trauma; airway management; sepsis
Prof. Dr. Shigeaki Inoue

E-Mail Website
Guest Editor
Department of Disaster and Emergency Medicine, Kobe University Graduate School of Medicine, Kusunoki-cho 7-5-2, Chuo-ward, Kobe, Japan
Interests: post-intensive care syndrome; ICU-acquired weakness; aging; immunosenescence; sepsis; end-of life
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Traumatic injury is a leading cause of death and disability, particularly among young people, and it carries with it a substantial economic burden for society. According to the World Health Organization, more than 5 million people die annually as a result of traumatic injuries, which accounts for 9% of the world’s deaths. This makes traumatic injury a major public health concern worldwide, and one that requires increasing attention.

In this Special Issue of Medicina, we aim to publish articles on the current therapies for trauma and surgical critical care in as broad a context as possible to provide readers with a comprehensive overview of the latest developments.

Clinical and experimental scientific research regarding innovative approaches to trauma resuscitation are welcome.

Case reports, retrospective and prospective case series and studies, literature reviews, opinions, and clinical and basic scientific research are all welcome.

The goal of this Special Issue is to improve the resuscitation of injured patients by gathering high-quality evidence of the best approaches.

Dr. Yuko Ono
Prof. Dr. Shigeaki Inoue
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • severe trauma
  • trauma anesthesia
  • trauma critical care
  • trauma surgery
  • systemic inflammatory syndrome
  • interventional radiology
  • prehospital trauma care
  • epidemiology
  • basic research

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Published Papers (4 papers)

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Research

14 pages, 4564 KiB  
Article
Baseline Characteristics Associated with Improved Outcomes in Patients Undergoing Primary Decompressive Craniectomy for Acute Subdural Hematoma Evacuation—A Retrospective Observational Study
by Rimantas Vilcinis, Raimondas Juskys, Lukas Piliponis and Arimantas Tamasauskas
Medicina 2025, 61(2), 288; https://doi.org/10.3390/medicina61020288 - 7 Feb 2025
Viewed by 637
Abstract
Background and Objective: The study’s aim is to identify a subgroup of patients who would benefit from primary decompressive craniectomy (pDC) after acute subdural hematoma (aSDH) evacuation. Materials and Methods: A retrospective analysis of 290 patients undergoing aSDH evacuation between 2016 [...] Read more.
Background and Objective: The study’s aim is to identify a subgroup of patients who would benefit from primary decompressive craniectomy (pDC) after acute subdural hematoma (aSDH) evacuation. Materials and Methods: A retrospective analysis of 290 patients undergoing aSDH evacuation between 2016 and 2021 was conducted. Osteoplastic craniotomy (OC) was performed in 213 cases (73.4%), whereas 77 individuals underwent pDC. Preoperative characteristics, such as age, initial GCS score, hematoma thickness, midline shift, and cisternal effacement score (CES), were used to predict outcome at discharge by the Glasgow Outcome Scale (GOS). Results: Older age, lower initial GCS, and higher CES preoperatively were independently associated with lower GOS scores at discharge. Age and degree of cisternal compression remained significant predictors of GOS score in the pDC subgroup. Survivors who underwent pDC were younger in comparison to deceased individuals receiving OC (mean age 55.43 ± 14.58 vs. 72.28 ± 14.63, p < 0.001). Patients who achieved favorable outcomes after pDC were significantly younger compared to those who had poor outcomes after OC (mean age 49.20 ± 12.05 vs. 72.28 ± 14.32, p < 0.001). Conclusions: Younger patients (<55 years old) with initial GCS scores of 4–6, midline shifts of 1 to 2 cm, subdural hematoma thickness of 1 to 2.5 cm, and CES in a range of 7–12 may benefit from pDC as it could potentially improve survival and functional outcomes after aSDH evacuation. Full article
(This article belongs to the Special Issue Current Therapies for Trauma and Surgical Critical Care)
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11 pages, 1134 KiB  
Article
Effects of a Serratus Anterior Plane Block After Video-Assisted Lung Wedge Resection: A Single-Center, Prospective, and Randomized Controlled Trial
by Seokjin Lee, Tae-Yun Sung, Choon-Kyu Cho, Gyuwon Lee and Woojin Kwon
Medicina 2025, 61(1), 11; https://doi.org/10.3390/medicina61010011 - 26 Dec 2024
Viewed by 836
Abstract
Background and Objectives: Video-assisted thoracoscopic surgery (VATS) is associated with less postoperative pain than traditional open thoracotomy. However, trocar and chest tube placement may damage the intercostal nerves, causing significant discomfort. An ultrasound-guided serratus anterior plane block (SAPB) is a promising mode [...] Read more.
Background and Objectives: Video-assisted thoracoscopic surgery (VATS) is associated with less postoperative pain than traditional open thoracotomy. However, trocar and chest tube placement may damage the intercostal nerves, causing significant discomfort. An ultrasound-guided serratus anterior plane block (SAPB) is a promising mode of pain management; this reduces the need for opioids and the associated side-effects. This study evaluated whether SAPB, compared to intravenous analgesia alone, reduces opioid consumption after thoracoscopic lung wedge resection. Materials and Methods: In total, 22 patients undergoing VATS lung wedge resections were randomized into two groups (SAPB and control): both received intravenous patient-controlled analgesia (PCA), and one group received additional SAPB. The primary outcome was the cumulative intravenous fentanyl consumption at 8 h postoperatively. The visual analog scale (VAS) pain scores and the incidence of postoperative complications were assessed over 48 h post surgery. Results: Fentanyl consumption by 8 h post surgery was significantly lower in the SAPB group than in the control group (183 ± 107 μg vs. 347 ± 202 μg, p = 0.035). Although the VAS scores decreased with time in both groups, the differences were not statistically significant. The SAPB group required fewer opioids by 48 h. No significant between-group differences were observed in postoperative complications, including nausea and vomiting. Conclusions: SAPB effectively reduced opioid consumption after VATS lung wedge resection. SABP may serve as a valuable component of multimodal pain management. Full article
(This article belongs to the Special Issue Current Therapies for Trauma and Surgical Critical Care)
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11 pages, 2116 KiB  
Article
Therapeutic Potential of Vitamin B Complex in Peripheral Nerve Injury Recovery: An Experimental Rat Model Study
by Ahmet Kahraman, Metin Temel, Numan Atilgan, Ahmet Saray and Recep Dokuyucu
Medicina 2024, 60(9), 1556; https://doi.org/10.3390/medicina60091556 - 23 Sep 2024
Cited by 2 | Viewed by 3546
Abstract
Objectives: Vitamin B complexes are frequently used in clinical practice for peripheral nerve trauma. However, there is a lack of scientific data on their effectiveness. This study aims to investigate the impact of the vitamin B complex on nerve recovery in a [...] Read more.
Objectives: Vitamin B complexes are frequently used in clinical practice for peripheral nerve trauma. However, there is a lack of scientific data on their effectiveness. This study aims to investigate the impact of the vitamin B complex on nerve recovery in a rat model of peripheral nerve paralysis. Materials and Methods: Sixty male Wistar Albino rats were divided into six groups. Models of nerve injury, including blunt trauma, nerve incision, and autograft, were performed on all rats approximately 1 cm distal to the sciatic notch. B-complex vitamins were injected intraperitoneally at 0.2 mL/day to the treatment groups. The control groups were given 0.2 mL/day saline. After 1 month, the study was terminated, electromyography (EMG) was performed to measure the conduction velocity, and nerve tissue was taken from the repair line. The sciatic function indexes (SFIs) were calculated and analyzed. The histopathological samples were stained with hematoxylin and eosin and Toluidine blue and examined with a light microscope. Pathologically, myelination, fibrosis, edema, and mast cell densities in the nervous tissue were evaluated. Results: The vitamin B treatment groups demonstrated significant improvements in SFI compared to the control groups, indicating functional improvement in nerve damage (p < 0.05). In the nerve graft group, the vitamin B group showed a shorter latency, higher velocity, and larger peak-to-peak compared to the controls (p < 0.05). In the nerve transection group, the vitamin B group had better latency, velocity, and peak-to-peak values than the controls (p < 0.05). In the crush injury group, the vitamin B group exhibited an improved latency, velocity, and peak-to-peak compared to the controls (p < 0.05). Better myelination, less fibrosis, edema, and mast cells were also in the vitamin B group (p < 0.05). Conclusions: Vitamin B treatment significantly improves nerve healing and function in peripheral nerve injuries. It enhances nerve conduction, reduces fibrosis, and promotes myelination, indicating its therapeutic potential in nerve regeneration. Full article
(This article belongs to the Special Issue Current Therapies for Trauma and Surgical Critical Care)
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11 pages, 1447 KiB  
Article
Evaluation of the Impact of a Less-Invasive Trunk and Pelvic Trauma Protocol on Mortality in Patients with Severe Injury by Interrupted Time-Series Analysis
by Tokiya Ishida, Yudai Iwasaki, Ryohei Yamamoto, Nozomi Tomita, Kazuaki Shinohara, Kaneyuki Kawamae and Masanori Yamauchi
Medicina 2024, 60(8), 1338; https://doi.org/10.3390/medicina60081338 - 18 Aug 2024
Viewed by 1189
Abstract
Background and Objectives: Minimally invasive trauma management, including interventional radiology and non-operative approaches, has proven effective. Consequently, our hospital established a trauma IVR protocol called “Ohta Nishinouchi Hospital trauma protocol (ONH trauma protocol) in 2013, mainly for trunk trauma. However, the efficacy [...] Read more.
Background and Objectives: Minimally invasive trauma management, including interventional radiology and non-operative approaches, has proven effective. Consequently, our hospital established a trauma IVR protocol called “Ohta Nishinouchi Hospital trauma protocol (ONH trauma protocol) in 2013, mainly for trunk trauma. However, the efficacy of the ONH trauma protocol has remained unverified. We aimed to assess the protocol’s impact using interrupted time-series analysis (ITSA). Materials and Methods: This retrospective cohort study was conducted at Ohta Nishinouchi hospital, a tertiary emergency hospital, from January 2004 to December 2019. We included patients aged ≥ 18 years who presented to our institution due to severe trauma characterized by an Abbreviated Injury Scale of ≥3 in any region. The primary outcome was the incidence of in-hospital deaths per 100 transported patients with trauma. Multivariable logistic regression analysis was conducted with in-hospital mortality as the outcome, with no exposure before protocol implementation and with exposure after protocol implementation. Results: Overall, 4558 patients were included in the analysis. The ITSA showed no significant change in in-hospital deaths after protocol induction (level change −1.49, 95% confidence interval (CI) −4.82 to 1.84, p = 0.39; trend change −0.044, 95% CI −0.22 to 0.14, p = 0.63). However, the logistic regression analysis revealed a reduced mortality effect following protocol induction (odds ratio: 0.50, 95% CI: 0.37 to 0.66, p < 0.01, average marginal effects: −3.2%, 95% CI: −4.5 to −2.0, p < 0.01). Conclusions: The ITSA showed no association between the protocol and mortality. However, before-and-after testing revealed a positive impact on mortality. A comprehensive analysis, including ITSA, is recommended over before-and-after comparisons to assess the impact of the protocol. Full article
(This article belongs to the Special Issue Current Therapies for Trauma and Surgical Critical Care)
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