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Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Open abdomen is an alternative for the management of trauma patient, and negative pressure therapy of the wound using VAC ® device is a genuine sort of treatment. Although the device poses technical advantages, risks are present and a critical complication is the enteroatmospheric fistula formation (EAF)., Objective: To analize the role of negative pressure therapy length and VAC ® device number of changes on the EAF formation in trauma patients udergoing open abdomen., Method: Cut-off points were calculated using receiver operational characteristics curve. Values were compared with Student's t or Mann-Withney U tests, considering statistically significant p < 0.05., Results: EAF were present in 39 cases (5.9%). A significant difference in the presence of EAF was present in patients with negative pressure therapy of the wound length ≥ 11.2 days (46.9 vs. 1.3%; relative risk [RR]: 3.67; 95% confidence interval [95% IC]: 2.4-6.68; p = 0.017) and when ≥ 2.6 VAC ® device changes were performed (34.6 vs. 0.5%; RR: 6.92; 95% IC: 1.1-4.3; p < 0.001)., Conclusions: At our institution, the practice of >3 VAC ® device changes and length of therapy > 11 days should be carefully considered leading to reduce the risk of EAF formation., (Copyright: © 2023 Permanyer.)

Trauma to peripheral vascular organ is a very frequent condition during military conflicts. Fortunately, comprehensive understanding of local and systemic pathophysiology, in addition to the development of innovative surgical techniques and technological advances, have improved the outcome regarding to survival and anatomic and functional conservation of the limbs. In this manuscript, we perform an historical and state of the art review related to the approach of the peripheral vascular trauma, on the basis of an heroical episode from the Mexico City's Campaign, during North American invasion 1846-1848: the defense of Chapultepec's Castle by cadet Agustin Melgar., (Copyright: © 2020 Permanyer.)

Background: Shotgun injuries (SGI) are infrequent, but due its special ballistics, are related to adverse outcomes., Objective: To analyze operative and administrative variables, critical for the institution., Method: Demographics and health-care related variables from SGI patients admitted to Military Central Hospital (Mexico City) between July 2006 and August 2019, were retrospectively studied. Statistics methods used were dispersion measures and relative occurrence frequency., Results: Over a 15 months-span, 21 SGI patients were admitted. Mean age was 36.9 ± 13.6 years (range: 14-61) and male gender was dominant (n = 20; 95%). Type II SGI were the most common injuries (62%; 13/21). Mean hospital length of stay was 37.1 ± 28.7 days (range: 3-109) while stay at ICU was 20.3 ± 22.5 days (range: 3-99). Global rate of morbidity was 82% (17/21) and most frequent complications were infective. Global mortality rate was 24% (5/21)., Conclusions: Once SGI cause prolonged length of stay, high rate of morbidity and of enormous consuming of material and human resources, primary prevention strategies are convenient for health-care systems compromised to the care of these cases., (Copyright: © 2020 Permanyer.)

Background: Maternal morbidity and mortality pose a significant impact on national public health, being medical attention of obstetric emergencies (OE) and non-emergencies (ONE) of capital importance., Methods: Descriptive and epidemiologic analysis of OE/ONE at a 3rd level military echelon., Results: During a 34-months span, 48 patients were approached at the emergency department (1.4 admissions/month). Mean age: 29 ± 3 years (17-41). Eight patients (17%) were considered OE and 40 (83%) ONE. Fifty-eight percent (n = 28) of patients were admitted to our institution; 32% (n = 9) were managed under non-surgically basis and 68% (n = 19) underwent surgical therapy. Most important cause of admission: postoperative hemorrhage (22%; n = 6). Most frequent operative interventions: surgical hemostasis maneuvers (31.5%; n = 6). Eighty-two percent (n = 23) of admissions required management at intensive care unit (ICU), with mean length of stay of 6.4 ± 4.9 days (2-21). Thirty-five percent (n = 8) required mechanical ventilation. Mean score of APACHE II at ICU: 19.4 ± 8.4; predicted probability of death: 35.5%. Global morbidity rate: 27% (1.8 complications/patient). Global mortality rate: 6.2%; specific mortality for pregnant patients 0% (n = 0) and for post-partum patients12.5% (n = 3). Mortality rate at ICU: 4.3% (n = 1)., Conclusions: Central Military Hospital has delineated and defined several procedures to decrease maternal morbidity and mortality. Appropriate practice of these procedures contributes to reach the desired institutional objectives., (Copyright: © 2018 Permanyer.)