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Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing 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 Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing 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.)

Despite their wounding potential, air guns are accepted as low-profile weapons or toys, and are not considered as lethal weapons. The aims of this study are to determine the wounding potential of air guns and to increase the consciousness about the dangers of the air guns. The kinetic energy limits are mentioned in 11 different countries’ legislations are evaluated with respect to test results. Twelve Kraton RTM G1 (15%) Transparent Ballistic Candle Blocks were prepared as the artificial soft-tissue test media in three different test models. A 4.5 mm air pistol and a 5.5 mm air rifle were used in the tests, which were performed in 1 and 10 m ranges. The mean penetration depth of the air pistol shots was 25.60 mm and the air rifle penetration was 79.14 mm from the 1 m range for three test models. In the 10 m range, the mean penetration depth of air pistol shots was 25.30 mm, while 79.19 mm was recorded for the air rifle. Considering these penetration depths, shots at especially the neck, eyes and thorax regions, can cause fatal injuries. For that reason, the kinetic energy limits should be the main point of air gun restrictions. [ABSTRACT FROM PUBLISHER]

Copyright of Meme Sagligi Dergisi / Journal of Breast Health is the property of Turkish Federation of Breast Diseases Associations 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 Erciyes Medical Journal / Erciyes Tip Dergisi is the property of KARE Publishing 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.)

Mesenteric ischemia due to arterial occlusion is still an important cause of mortality and morbidity. The goal of medical and surgical therapies is to restore decreased mesenteric circulation for the purpose of preventing intestinal ischemia or necrosis, malnutrition, weight loss and postprandial abdominal pain. Anticoagulant agents, percutaneous transluminal angioplasty, balloon / stent applications, and bypass surgery are preferred treatment alternatives. A successful iliaco- mesenteric bypass performed for a chronic superior mesenteric artery ischemia and it's 24 month follow up is presented in this case report in view of current literature. [ABSTRACT FROM AUTHOR]

Stump viscera caused by an incomplete operation can present the same symptoms as before the first operation. Furthermore, as an acute clinical event, these incomplete resections may sometimes cause acute abdomen and may need emergency surgical intervention. A 34-year-old woman with a history of laparoscopic cholecystectomy 5 days before was admitted with acute abdominal symptoms. Abdominal exploration revealed that she had undergone incomplete resection of the gallbladder. Another patient, a 21-year-old man, was admitted with complaints of fluid drainage from his appendectomy incision scar. He was diagnosed as having enterocutaneous fistula. Abdominal exploration revealed a stump appendix fistulizing to the abdominal wall. The third patient was a 32-year-old man with an appendectomy scar who was admitted with complaints of acute appendicitis. The patient was diagnosed as having acute appendicitis and underwent an appendectomy. A stump appendix was removed during the operation. Surgeons should be aware of stump pathologies and keep in mind a possible incomplete operation to prevent delayed diagnosis and treatment. [ABSTRACT FROM AUTHOR]

The fragmentation impact of high-velocity bullets penetrating the body after piercing through the magazines carried by soldiers was investigated experimentally. In this study, 16 pigs and 7.62x51-mm full metal jacket bullets were used. Pigs were assigned into two groups, and within 5 minutes of their being sacrificed with overdose anesthesia, bullets were fired into the first group on which magazines were placed and into the second group on which magazines were not placed, targeting abdominal left lower quadrant. It was found that in pigs not carrying magazines, all bullets pierced through the pig; bullets were not fragmented. However, in pigs with magazines, common fragmentation in bullets and multiple organ perforations occurred. It was concluded that magazines caused the bullets to be fragmented, increasing tissue and organ damage. [ABSTRACT FROM AUTHOR]

Background: Bleeding remains the leading cause of potentially preventable deaths both in military and civilian pre-hospital trauma settings. Conventional extremity tourniquets do not control bleeding if an iliac artery or a common femoral artery is injured. Stopping junctional bleeding is particularly challenging and requires the use of specifically designed junctional tourniquets. SAM® Junctional Tourniquet (SJT®, United States of America) and Tactical Abdominal Junctional Tourniquet (T-AJT®, Fora Group Türkiye) have been actively used by Turkish security forces. This study questioned the effect of training on combat medics' successful junctional tourniquet applications and application times (AT)., Methods: Our research on two different junctional tourniquet models was designed as a prospective randomized, crossover, single-blinded study. All 40 participants in the study were attendees of a 12-week combat medic training course with updated medical approvals, which were used as an eligibility criterion. Randomization was performed by drawing T-AJT®-SJT cards. The study consisted of pretraining and after-training tourniquet application phases. In each study phase, all participants' AT and the presence or absence of arterial flow were recorded for each group. Finally, the combat medics were presented with a 6-question survey., Results: Although training increased successful T-AJT® application rates, training was not statistically significantly associated with successful applications for any tourniquet types (p>0.05). The pretraining phase ATs for SJT® and T-AJT® were 55±11.8 and 93.8±2.9 seconds, respectively, and the difference was statistically significantly different (p<0.001). Likewise, after-training phase ATs for SJT® and T-AJT® were 49±22.6 and 79.2±17.5 seconds, respectively, and participants' SJT® ATs were significantly shorter (p<0.001). Overall, when participants' applied any of the tourniquet unsuccessfully, the odds of participants' lower Visual Analogue Scale scores were 0.2 (95% CI [0.08, 0.49]. p<0.001)., Conclusion: Our study basically investigates the effects of training on effective tourniquet application. Unfortunately, our after-training success rates remained unsatisfactory when compared to other studies. This is also the first study on T-AJT® tourniquet application, and further studies on its efficacy are also required.

Background: In this study, a 35 years old man was killed with the ricocheted shotgun pellets wounds from the asphalt road surface. The Public Prosecutor to define the ricochet point requested the ricocheted pellet pattern examination in two different ricochet distances., Methods: The ten ricochet tests were performed for at 2 meters (point A) and 1 meter (point B) from the target, and the pellet distribution and pattern area were calculated using the gauss method. Then, the test and autopsy results were compared in the pellet number, calculated pellet pattern area and ricocheted angle. Furthermore, the similarity of the pellet number and the pellet pattern areas were examined using the two-tailed Mann-Whitney U test., Results: In this study, 81 pellets recovered from the victim's body and the distribution pattern of pellets area was 2134 cm2. At the ricochet point A, the average number of pellets on the target was 82.1 and the distribution pattern of pellets area was 2700 cm2. At the ricochet point B, the average number of pellets on the target was 132.6 and the distribution pattern of pellets area was 4928 cm2. According to the two-tailed Mann-Whitney U test, there was low-level similarity (p<0.05 level Sig. 0.023; z=-2.424) on the pellet pattern area between autopsy and the ricochet point A. However, as regards the pellet number on the target, there was a similarity (p<0.05 level Sig. 0.481; z=-0.808) between autopsy and the ricochet point A., Conclusion: Test results showed that the pellet ricochet occurred two meters from the victim.

Background: It was aimed in this study to clarify the wounding potential of free-falling bullets fired at 90° or close to right angles., Mehtohds: In this study, 9x19 mm and 7.65x17 mm bullets, which are commonly used among civilians, were used. The muzzle velocities of these ammunitions were measured. According to the muzzle velocity data, the free-falling motion and strike velocity of the 9x19 mm and 7.65x17 mm bullets were simulated using the EBV4® External Ballistics Software at angles of 65°-90° with firings at 5° intervals. The simulation results were compared with critical velocity of tissues. In addition, the judicial records and press reports on this type of wound were examined and evaluated in light of the literature., Results: The strike velocity and kinetic energy of free-falling bullets, which were fired into the air at 5° intervals between 65°-90°, were measured. The average strike velocity and kinetic energy of 9x19 mm bullets were 92.25 m/sec and 34.05 J and of 7.65x17 mm bullets were 79.66 m/sec and 14.91 J, respectively. As a result of the archives examination, 65 such wounds were detected between 2000 and 2012, and 27 of them resulted in death., Discussion: According to these results, the strike velocity of free-falling 9x19 mm and 7.65x17 mm bullets, which were fired into the air, exceeds the threshold and critical velocity limits of skin and flat bones, and the kinetic energy of the bullets is able to cause significant wounding. Even though the symptoms and features of these types of wounds may not be similar to those of ordinary gunshot wounds in the first medical examination, the first responders should be aware of the possibility of gunshot wounds, and they should take into account the criminal investigation phase during the treatment process; the necessary precautions should be taken in order to preserve the evidence.

Background: Uncontrolled hemorrhage is the leading cause of fatality. The aim of this study was to evaluate the effect of zeolite mineral (QuikClot - Advanced Clotting Sponge [QC-ACS]) on blood loss and physiological variables in a swine extremity arterial injury model., Methods: Sixteen swine were used. Oblique groin incision was created and a 5 mm incision was made. The animals were allocated to: control group (n: 6): Pressure dressing was applied with manual pressure over gauze sponge; or QC group (n: 10): QC was directly applied over lacerated femoral artery. Mean arterial pressure, blood loss and physiological parameters were measured during the study period., Results: Application of QC led to a slower drop in blood pressure. The control group had a significantly higher increase in lactate within 60 minutes. The mean prothrombin time in the control group was significantly increased at 60 minutes. The application of QC led to decreased total blood loss. The QC group had significantly higher hematocrit levels. QC application generated a significant heat production. There were mild edematous and vacuolar changes in nerve samples., Conclusion: According to the physiological parameters, we observed that zeolite tends to reduce blood loss, however could not stop bleeding completely. We believe that further clinical trials are needed to conclude that zeolite could be used in the routine practice.

Death caused by trauma is a major social problem in both the military and the civilian world. The goal is to reduce injuries and deaths to acceptable limits. Thus, healthcare providers should have the necessary information on trauma and resuscitation and be aware of current principles of approach to trauma patients. Early life-saving procedures in the trauma setting, damage control surgeries performed by an advanced line of surgical teams, and improvement in medical evacuation systems provide effective treatment in trauma casualties and reduce the mortality rate. Significant changes have occurred recently in the treatment of trauma cases. In our study, we aimed to search the literature in order to describe the principles of proper medical approach, to review the operational strategies recommended in the field and to develop a consensus to the extent possible.

Background: Effects of various types and diameters of guns and related treatment principles are different. Our study was performed to experimentally demonstrate the effects of different gunshots in body tissues., Methods: 9x19 mm hand-gun and 7.62x51 mm G-3 infantry rifle were used in the study. Injury models were created through hand-gun and rifle shootings at isolated soft tissue, lower extremity, liver and intestine tissue simulants made of ballistic candle. High-speed cameras were used to capture 1000 frames per second. Images were examined and wound mechanisms were evaluated., Results: It was observed that the colon content distributed more within the surrounding tissues by the rifle shootings comparing with hand-gun shootings and could be an infection source due to the large size of the cavity in the colon. Especially when the bullets hitting the bone were investigated, it was seen that much more tissue injury occurs with high speed bullets due to bullet deformation and fragmentation. However, no significant difference was found between the effect of hand-gun and rifle bullets passing through the extremity without hitting the bone., Conclusion: To know the type of the gun that caused the injury and its characteristics will allow to estimate severity and size of the injury before the treatment and to focus on different alternatives of treatment. Therefore, use of appropriate models is required in experimental studies.

Background: Inanimate tissue stimulants have been used to show the bullet effects in ballistic studies. Gelatin has been being used as a ballistic stimulant for the last 20 years. It was considered that transparent gel candle (kraton in white paraffin oil) might be used as a soft tissue stimulant that can be an alternative for gelatin., Methods: For calibration of transplant gel candle, firstly it was shot at the 10% ordinance gelatin at 4 o C, and several concentrations of the transparent gel candle at 4 o C, by later on, by using a competition air gun. It was seen that 15% kraton in 85% white paraffin oil is the most suitable concentration. This kind of transparent gel candle blocks tested by using 9 mm parabellum and 7.62 mm x 51 (NATO 7.62) infantry rifle bullets and high-speed camera., Results: Because of its transparency and elasticity, the penetration, permanent and temporary cavities of bullets were observed clearly in transparent gel candle., Conclusions: As a result, transparent gel candle is a good soft tissue stimulant that it can be used in wound ballistic studies.