Acute nerve injuries are routinely encountered in multisystem trauma patients. Advances in surgical treatment of nerve injuries now mean that good outcomes can be achieved. Despite this, old mantras associated with management of nerve injuries, including “wait a year to see if recovery occurs” and “there’s nothing we can do”, persist. Practicing by these mantras places these patients at a disadvantage. Changes begin to occur in the nerve, neuromuscular junction, and muscle from the moment a nerve injury occurs. These changes can become irreversible approximately 18-24 months following denervation. Thus, it is a race to reestablish a functional nerve-muscle connection prior to these irreversible changes. Good outcomes rely on appropriate acute management and avoiding delays in care. Primary nerve surgery options include direct primary repair, nerve graft repair, and nerve transfer. Acute management of nerve injuries proceeds according to the rule of 3s and requires early cooperation between trauma surgeons who recognize the nerve injury and consultant nerve surgeons. Care of patients with acute, traumatic nerve injuries should not be delayed. Awareness of current management paradigms among trauma surgeons will help facilitate optimal upfront management. With the ever-expanding surgical options for management of these injuries and the associated improvement of outcomes, early multidisciplinary approaches to these injuries has never been more important. Old mantras must be replaced with new paradigms in order to continue to see improvements in outcomes for these patients. The importance of this review is to raise awareness among trauma surgeons of new paradigms for management of traumatic nerve injuries. CORRESPONDENCE: Thomas J. Wilson, MD, Department of Neurosurgery, Stanford University, 300 Pasteur Drive, R293, Stanford, CA 94305-5327, Phone: (650)723-0320; Fax: (650)724-9912, E-mail: wilsontj@stanford.edu CONFLICTS OF INTEREST/SOURCES OF FUNDING: None to declare © 2018 Lippincott Williams & Wilkins, Inc.
from Emergency Medicine via xlomafota13 on Inoreader https://ift.tt/2O4Lo4w
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
Δημοφιλείς αναρτήσεις
-
Champion EMS is currently seeking a Communications Center Manager. Champion EMS is based out of Longview, Texas, serving the East Texas area...
-
from EMS via xlomafota13 on Inoreader http://ift.tt/2sbML2K
-
from EMS via xlomafota13 on Inoreader http://ift.tt/2sbML2K
-
from EMS via xlomafota13 on Inoreader http://ift.tt/2sbML2K
-
from EMS via xlomafota13 on Inoreader http://ift.tt/2sbML2K
-
Remove ads BioMed Research International Validity and Reliability of the Polish Adaptation of the CHAMPS Physical Activity Questionnaire Th...
-
If you’re attacked on the job, be mentally prepared, physically ready, press savvy, and able to justify your actions in court from EMS via...
-
How the activity of natural enemies changes the structure and metabolism of the nutritive tissue in galls? Evidence from the Palaeomystella ...
-
The Cleveland Clinic shows how the Mobile Stroke Unit by Excellance saves brain function and lives. from EMS via xlomafota13 on Inoreader ...
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου