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The cult of saints in Western Europe developed during the late period of antiquity and the early Middle Ages. Their importance to European society was undeniable; holy medicine was the only hope for people, because there were no doctors. The number of saints had increased over the years, and people sought medical help from them through prayer and other religious practices. Some of the saints became "specialized" in treating various wounds and dermatologic diseases. During our research, we tried to determine whether the cult of saints led to the develop-ment of hospitals that treated skin diseases, as discovered in the Hospital Brother of Saint Anthony. A large number of saints who were patrons of wounds and skin diseases were collected in three studies. In the first report, we presented a great number of saints who were patrons to treat animal bites. The second report presented patron saints of wounds, ulcers, burns, and frostbites; and the third report decsribed saints who treated contagious diseases (such as ergotism, leprosy, and scabies). The phenomenon of holy medicine is part of the history of dermatology and is important due to "specializations," which refer to an understanding of skin diseases and the methods of treating various wounds and dermatologic diseases.

This article aims to analyze the types of surgical diseases and treatments in ancient China as documented in bamboo and silk texts, with a particular focus on (external) injury, tetanus, burns, rectal and anal diseases, and inguinal hernias. For this analysis, I gathered 85 instances of disease and treatments recorded in these texts. The 85 cases were further categorized into 13 (external) injuries, 13 metal wounds, 6 tetanus, 22 burns, 16 rectal and anal diseases, and 15 inguinal hernias. The analysis revealed that the treatment of (external) injury and burns focused primarily on the wound site, while the treatment of metal wounds and tetanus centered on addressing the internal body. Internal treatments were mainly prescribed through the use of medicine and food. Surgical intervention was recommended primarily for diseases of the rectum and anus, with medications applied to the woundspost-surgery. For inguinal hernias, a high-protein diet was typically prescribed. As we've seen, in ancient China, surgical diseases were mainly treated with medication, surgery, and dietary prescriptions. And among these prescriptions, drug prescriptions were utilized not only by medical doctors but also by witch-doctors treating diseases in civilian society and soldiers stationed at frontline military posts. In the absence of medical doctors in both civilian society and frontline units, witch-doctors and frontline units purchased or stockpiled prescription drugs and used them to treat patients according to prescription.

Abstract: This is a literature review on the history of venous trauma since the 1800s, especially that to the common femoral, femoral and popliteal veins, with focus on the early 1900s, World War I, World War II, Korean War, Vietnam War, and then civilian and military reviews (1960-2020). In the latter two groups, tables were used to summarize the following: incidence of venous repair versus ligation, management of popliteal venous injuries, patency of venous repairs when assessed <30 days from operation, patency of venous repairs when assessed >30 days from operation, clinical assessment (edema or not) after ligation versus repair, incidence of deep venous thrombosis after ligation versus repair, and incidence of pulmonary embolism after ligation versus repair.There is a lack of the following in the literature on the management of venous injuries over the past 80 years: standard definition of magnitude of venous injury in operative reports, accepted indications for venous repair, standard postoperative management, and timing and mode of early and later postoperative assessment.Multiple factors have entered into the decision on venous ligation versus repair after trauma for the past 60 years, but a surgeon's training and local management protocols have the most influence in both civilian and military centers. Ligation of venous injuries, particularly those in the lower extremities, is well tolerated in civilian trauma, although there is the usual lack of short- and long-term follow-up as noted in many of the articles reviewed., Level of Evidence: Review article, levels IV and V., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Archaeological excavations close to St Louis' castle in Sidon, Lebanon have revealed two mass grave deposits containing partially articulated and disarticulated human skeletal remains. A minimum of 25 male individuals have been recovered, with no females or young children. Radiocarbon dating of the human remains, a crusader coin, and the design of Frankish belt buckles strongly indicate they belong to a single event in the mid-13th century CE. The skeletal remains demonstrate a high prevalence of unhealed sharp force, penetrating force and blunt force trauma consistent with medieval weaponry. Higher numbers of wounds on the back of individuals than the front suggests some were attacked from behind, possibly as they fled. The concentration of blade wounds to the back of the neck of others would be compatible with execution by decapitation following their capture. Taphonomic changes indicate the skeletal remains were left exposed for some weeks prior to being collected together and re-deposited in the defensive ditch by a fortified gateway within the town wall. Charring on some bones provides evidence of burning of the bodies. The findings imply the systematic clearance of partially decomposed corpses following an attack on the city, where adult and teenage males died as a result of weapon related trauma. The skeletons date from the second half of the Crusader period, when Christian-held Sidon came under direct assault from both the Mamluk Sultanate (1253 CE) and the Ilkhanate Mongols (1260 CE). It is likely that those in the mass graves died during one of these assaults., Competing Interests: The authors have declared that no competing interests exist.

Prehospital hypotension has been utilized for decades as a surrogate marker of injury severity. Several studies have discussed the correlation between injury and hypotension both in the field as well as in the emergency department. Increases have been noted in injury severity score and mortality. Resource utilization is higher in this patient population. This study revisits our original work from 2000 and reviews the current literature regarding hypotension and injury severity. We also examine the role of prehospital hypotension as an indicator of trauma team activation and resource allocation. This review serves as a part of a Literary Festschrift in honor of Dr J David Richardson's role as the Editor-in-Chief of The American Surgeon.

Data on injury-related mortality are scarce in the African region. Mortality from external causes in the Seychelles was assessed, where all deaths are medically certified and the population is regularly enumerated. The four fields for underlying causes of death recorded were reviewed in the national vital statistics register. The age-standardised mortality rates were estimated (per 100,000 person-years) from external causes in 1989-1998, 1999-2008, and 2009-2018. Mortality rates per 100,000 person-years from external causes were 4-5 times higher among males than females, and decreased among males over the three 10-year periods (127.5, 101.4, 97.1) but not among females (26.9, 23.1, 26.9). The contribution of external causes to total mortality did not change markedly over time (males 11.6%, females 4.3% in 1989-2018). Apart from external deaths from undetermined causes (males 14.6, females 2.4) and "other unintentional injuries" (males 14.1, females 8.0), the leading external causes of death in 2009-2018 were drowning (25.9), road traffic injuries (18.0) and suicide (10.4) among males; and road traffic injuries (4.6), drowning (3.4) and poisoning (2.6) among females. Mortality from broad categories of external causes did not change consistently over time but rates of road traffic injuries increased among males. External causes contributed approximately 1 in 10 deaths among males and 1 in 20 among females, with no marked change in cause-specific rates over time, except for road traffic injuries. These findings emphasise the need for programs and policies in various sectors to address this large, but mostly avoidable health burden.

The study presented here analyzes mining accidents and fatal injuries in Serbian underground coal mines over a period of 50 years, in order to assess the effectiveness of legislation changes in the overall safety of work environment. Two distinct periods, prior to 2000 and after 2000 were compared. The data from the period after 2000 were further analyzed to provide better understanding of the results. In order to assess the overall state of safety in Serbian mines, the data on fatal injuries were also compared to the international data. It was found that the legislative changes are more easily accepted by the common workers than by the mine management. Consequently, the key recommendation for the safety of coal mine companies in Serbia is the investment in the new technology. Additionally, mine management should be in the focus of the mining inspection with a stronger penal policy regarding mine safety neglect.

Since the dawn of humanity, wounds have afflicted humans, and healers have held responsibility for treating them. This article tracks the evolution of wound care from antiquity to the present, highlighting the roles of surgeons, scientists, culture, and society in the ever-changing management of traumatic and iatrogenic injuries., Competing Interests: Disclosure None., (Copyright © 2020 Elsevier Inc. All rights reserved.)

In his review article John W. Verano covered trauma, warfare, trophy taking, and human sacrifice, but his discussion mostly focused on the results of studies of museum or private collections and the recent discovery of the mass human sacrifice from Huaca de la Luna. Due to the renewed interest in the paleopathology of South America, a trend which Verano observed, these types of investigations have grown exponentially in the past twenty years since his initial publication. Here we synthesize the published data on the study and interpretation of traumatic injuries across time and space and we tease out some of the themes that have emerged in the twenty odd years since the seminal paper written by Verano. We searched and analyzed publications from 1997 to 2017 that pertained specifically to Andean South America through the review of library databases and then narrowed our search to trauma-related topics. In our literature review and meta-analysis of published studies on traumatic injuries, we found that nearly one-third of publications related to the field of paleopathology in Andean South America dealt with subjects we classified under trauma (N = 116/378), such as trephination, violence, sacrifice, warfare, etc. Large sample sizes, population-focused research, advances in methods of analysis, and hypothesis driven investigations have led to sophisticated and nuanced interpretations along a wide range of themes so that we understand a great deal more about violence, sacrifice, trephination, warfare and their sociopolitical and environmental contexts in prehistoric and early colonial Andean South America., (Copyright © 2019. Published by Elsevier Inc.)

Not long after the beginnings of motorization in the early 1900s, deaths and injuries from motor vehicle crashes became a problem in a number of high-income-countries (HIC)s, especially the United States. With the biggest problem the US led early efforts to address this issue, and for six decades these efforts were based on folklore (ie a body of widely held but false or unsubstantiated beliefs). They were not evaluated, but clearly were unsuccessful as crash deaths and injuries continued to rise. It was not until the 1970s that a broader range of countermeasures began to be adopted and was scientifically evaluated, and as a result, crash deaths and injuries declined. This history has important lessons today for many low-and-middle-income countries that have growing numbers of motor vehicle crash deaths and injuries, many of which are pedestrians and motorcyclists. This is because there continue to be advocates for many of the failed approaches (especially educational) that dominated the early efforts in HICs.

Road traffic deaths in high-income countries (HICs) have been steadily declining for five decades, but are rising or stable in low- and middle-income countries (LMICs). We use time-series cross-sectional methods to assess how age- and sex- specific death rates evolved in 20 HICs during 1955-2015, controlling for income, population density and urbanization. Past work has attributed improvements in safety in HICs to income growth, suggesting that countries intervene when they become richer (Kuznets hypothesis). In contrast, we show that HICs had statistically significant declines in road traffic injuries starting in the late 1960s that persist after controlling for income effects, and inclusion of a lagged dependent variable. These findings are consistent for all age-sex groups but the effects are strongest for the elderly and young children. We argue that the reversal in the traffic injury trend did not occur because HICs reached an income threshold. Instead, the 1960s were a period of paradigmatic change in thinking about road safety. Subsequent, safety improvements occurred because countries at different income levels established regulatory institutions that had a legislative mandate and financial resources to conduct large-scale safety interventions.

Studies into violence in the eighteenth century tend to address questions related to justice and criminality, but not health. The aim of this study is to understand how, in eighteenth century Minas Gerais, Brazil, bodies were affected by violent acts. The investigation records from the parish of Vila Rica held at the historical archive of the Museu da Inconfidência were investigated. The results showed crimes of different kinds associated with a variety of motives, primarily crimes against the body, with the resulting bodily injuries being caused by sharp or pointed objects/instruments. There were more male victims than female, the head being the principal part of the body affected. Criminal and violent acts, very commonplace in this society, interfered in the health and disease processes of the bodies.

This research analyzes the role of the St. John's General Hospital in late nineteenth-century Newfoundland and Labrador using extant admission and discharge records from 17 May 1886 to 30 December 1899. Most individuals were discharged from the hospital as "cured" or "convalescent." Trauma, musculoskeletal issues, and respiratory diseases were the most common reasons for admission, with males significantly more likely to seek care for trauma, sexually transmitted infections, and kidney/bladder issues. Female inpatients were significantly more likely to be admitted for tumours/cancers, anemia, digestive issues, and issues concerning the female anatomy. Notable were the short hospital stays for tuberculosis, indicating the General played an important role before the founding of the St. John's Sanatorium. A snapshot of late nineteenth-century morbidity reveals the complex risks facing citizens of St. John's and beyond who sought care at the General, which played a key role in the rapidly modernizing medical ecosystem.

This research explores how social and environmental factors may have contributed to conflict during the early Bronze Age in Northwest China by analyzing violent trauma on human skeletal remains from a cemetery of the Qijia culture (2300-1500 BCE). The Qijia culture existed during a period of dramatic social, technological, and environmental change, though minimal research has been conducted on how these factors may have contributed to violence within the area of the Qijia and other contemporaneous material cultures. An osteological assessment was conducted on 361 individuals (n = 241 adults, n = 120 non-adults) that were excavated from the Mogou site, Lintan County, Gansu, China. Injuries indicative of violence, including sharp- and blunt-force trauma that was sustained ante- or peri-mortem, were identified, and the patterns of trauma were analysed. Violent injuries were found on 8.58% (n = 31/361) of individuals, primarily adult males. No evidence of trauma was found on infants or children. Cranial trauma was found on 11.8% (n = 23/195) of the adult individuals examined. Of these, 43.5% (n = 10/23) presented with severe peri-mortem craniofacial trauma. The high rate of perimortem injuries and their locations indicate lethal intent. This lethality, in addition to the fact that individuals with trauma were predominantly male, suggest intergroup violence such as raiding, warfare, or feuding. Both social and environmental factors may have contributed to this conflict in the TaoRiver Valley, though future systematic archaeological and paleoenvironmental data will be needed to disentangle the many potential causal factors., (Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.)

This article traces the early history of military airborne operations and examines studies that have provided overall incidences of parachute-related injuries over time. The first US combat parachute assault was proposed during World War I, but the war ended before the operation could be conducted. Experimental jumps were conducted near San Antonio, Texas, in 1928 and 1929, but it was not until 1939, spurred by the developments in Germany, that the US Army Chief of Infantry proposed the development of an "air infantry." An Airborne Test Platoon was instituted with 48 men at Fort Benning, Georgia, and mass training of paratroopers began in 1940. The US entered World War II in December 1941 with the attack on Pearl Harbor and declaration of war by Germany. In January 1942, US War Department directed that four parachute regiments be formed. The 509th Parachute Infantry Battalion made the first US Army combat jumps into Morocco and Algeria in November 1942. At the US Army Airborne School in the 1940-1941 period, the parachute-related injury incidence was 27 injuries/1000 jumps; by 1993 it was 10 injuries/1000 jumps and in 2005-2006, 6 injuries/1000 jumps. Analysis of time-loss injuries in operational units showed a decline in injuries from 6 injuries/1000 jumps to 3 injuries/1000 jumps to 1 injury/1000 jumps in the periods 1946-1949, 1956-1962, and 1962-1963, respectively. When all injuries (not just time-loss) experienced in operational units are considered, the overall injury incidence was about 8 injuries/1000 jumps in the 1993- 2013 period. In jump operations involving a larger number of risk factors (e.g., high winds, combat loads, rough drop zones) injury incidences was considerably higher. The few studies that have reported on parachute-related injuries in combat operations suggest injury incidence ranged from 19 to 401 injuries/ 1000 jumps, likely because of the number of known injury risk factors present during these jumps. Despite the limitations of this analysis stemming from different injury definitions and variable risk factors, the data strongly suggest that military parachute injuries have sharply declined over time. Part 2 of this series will discuss techniques and equipment that have likely improved the safety of parachute operations., (2019.)

Objective: This study explores the differences in frequency and type of trauma found in two Medieval cemeteries in Denmark, as well as the cultural and community implications of those differences., Materials: We examined 235 skeletons from the cemetery at Tjærby (rural) and 170 skeletons from the cemetery at Randers (urban) for trauma from the Medieval period in Denmark, 1050 to 1536 CE., Methods: Trauma was assessed through macroscopic examination and odds ratio and relative risk assessments were run to assess the difference in trauma., Results: There was no significant difference in the presence of trauma between the rural and urban cemeteries or between males and females. There were some significant differences in relative risk for trauma between the two cemeteries., Conclusions: The division and variation in trauma between the two cemeteries is most likely related to differences in economy and occupation., Significance: There are relatively few studies that examine the difference in inherent risk of trauma between rural and urban Medieval communities, especially in Denmark. This research also adds to the growing body of literature in paleopathology that uses epidemiology to explore the parallels between patterns of trauma and community lifeways., Limitations: The cemeteries are approximately 5 km distance from each other so similarities in the sample could be a result of location., Suggestions for Further Research: A wider sample of Medieval cemeteries in Denmark needs be added to this analysis to provide a more complete picture of trauma patterns during this time period., (Copyright © 2018 Elsevier Inc. All rights reserved.)

The skeletal remains of the young female (20-24 years) from Grave JP/106, discovered in the Southern Suburb of the Břeclav - Pohansko Stronghold (Early Middle Ages, 9th century-beginning of the 10 th century, present day Czech Republic) display several noteworthy pathologies. The first is deformation of the mandible, which was most probably caused by a fracture of the ramus in combination with a subcondylar fracture. The spine of this young woman also exhibits a probable traumatic injury of the cervical spine in combination with a slowly growing structure situated inside the spinal canal, which caused deformation centered upon C7. The cervical and thoracic spine together with internal surfaces of several ribs exhibit infectious changes of advanced stage, in all likelihood of tuberculous origin, but osteomyelitis cannot be excluded. Histological analysis of the new bone formation in the ribs confirmed infectious origin, as does Micro CT of C5 and C6. Analyses conducted by two different departments with different methods (PCR amplification of 123 bp long section from IS6110 and Next Generation shotgun sequencing) failed to identify DNA of Mycobacterium tuberculosis from the first rib., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Objectives: In the scientific and medical field, authorship has become increasingly important for tenure and career advancement in addition to improvement in medical care. It was the purpose of this study to investigate changes in bibliometric variables, authorship, and collaboration trends in the Journal of Orthopaedic Trauma (JOT) and Injury over a 30-year period., Methods: A bibliometric analysis was completed for all manuscripts meeting the inclusion criteria and published throughout 1 representative year of each decade over the past 30 years. A total of 444 and 1105 manuscripts for JOT and Injury, respectively, met the inclusion criteria. Standard statistical analyses were performed with nonparametric methods for continuous variables and Pearson χ and Cochran linear trend tests for categorical variables. A P < 0.05 was considered statistically significant., Results: There were significant increases over time in all bibliometric variables for both journals, except in the number of countries and pages in JOT. For JOT, the overall percentage of female first authors increased 2.3 times from 1987 to 2015 (P = 0.021). The overall percentage of female corresponding authors was 7.3%. For Injury, the overall percentage of female first authors increased 1.5 times (P = 0.007). The overall percentage of female corresponding authors was 13.1%., Conclusions: Understanding changes in publishing characteristics over time and by region is critical with the rising demands of publishing in academic medicine. JOT and Injury have showed an increase in most variables analyzed. However, female authorship in JOT is climbing at a higher rate than Injury.

After a hiatus of several decades, the concept of cold whole blood (WB) is being reintroduced into acute clinical trauma care in the United States. Initial implementation experience and data grew from military medical applications, followed by more recent development and data acquisition in civilian institutions. Anesthesiologists, especially those who work in acute trauma facilities, are likely to be presented with patients either receiving WB from the emergency department or may have WB as a therapeutic option in massive transfusion situations. In this focused review, we briefly discuss the historical concept of WB and describe the characteristics of WB, including storage, blood group compatibility, and theoretical hemolytic risks. We summarize relevant recent retrospective military and preliminary civilian efficacy as well as safety data related to WB transfusion, and describe our experience with the initial implementation of WB transfusion at our level 1 trauma hospital. Suggestions and collective published experience from other centers as well as ours may be useful to those investigating such a program. The role of WB as a significant therapeutic option in civilian trauma awaits further prospective validation.

The presence of children in English voluntary hospitals during the eighteenth century has only recently come under academic scrutiny. This research examines the surviving admission records of the London Hospital, which consistently record inpatient ages, to illuminate the hospital stays of infant and child patients and examine the morbidity of children during the long eighteenth century. Traumatic cases were the most common category of admission. The proportion of trauma cases admitted to the London Hospital was higher than in provincial English child patient cohorts, potentially reflecting the differential risks faced by rural and urban children. In most cases of traumatic injury the inpatients stayed in hospital long enough for significant fracture healing to have occurred. Understanding the conditions surrounding children's admission to hospital, their length of stay, the result of their stay, and which medical issues drove their parents or guardians to seek medical attention for them are critical to illuminating the morbidity of children during the long eighteenth century.

Trauma and the need of medical care exist since the beginning of human history. This research is aimed to identify and analyze trauma in antiquity. After a review of bibliography, the first reports of trauma (in Europe) were found in the Greek Epics of Homer. The analysis of these texts showed that injury could be caused to any part of the human body. The main cause of trauma was primarily participation in wars (178 cases), and then participation in sports (6 cases) and other activities (6 cases). This study identified a total of 190 injuries in both Homer epics. The more serious injuries, many of which proved fatal, were observed from participation in military activities., (Copyright © 2018 Daping Hospital and the Research Institute of Surgery of the Third Military Medical University. Production and hosting by Elsevier B.V. All rights reserved.)

This article analyzes trauma in mid-twentieth century hospital births, focusing on the United States, but with additional evidence drawn from Great Britain and France. As many as half of women today experience childbirth as traumatic and no evidence suggests that the figure was lower a half-century ago. Drawing on women's birth narratives and psychiatric literature, this article highlights the striking consistency over time in how women describe their experiences of traumatic birth. By the 1970s, however, women proved less ready to accept their trauma as the product of their own psychological shortcomings. Under the sway of second-wave feminism, they pushed back against care they defined as inhumane in both conventional maternity care and in natural childbirth. Psychiatry too demonstrates change over time. Hegemonic at midcentury, Freudian thinking began to yield to critiques that questioned gender norms and the preeminence of the subconscious. Based on private letters to maternity caregivers and between physicians, as well as a wide array of medical journal articles, popular magazines, and newsletters from childbirth education and birth advocacy organizations, this article argues that, despite different approaches to trauma in birth and clarity about how best to minimize it, contemporary maternity care has to date proven unable to heed the lessons of history., (© The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Background: Childhood injuries are a global epidemic. Accidents resulting in childhood injury and death were first identified as a concern over a century ago. However, "accidents" leading to injury were not recognized as being predictable and preventable until more recently., Objectives: To describe the worldwide epidemic of childhood injuries, and look at international successes in the field of injury prevention., Methods: Literature pertaining to injury prevention was reviewed to describe the history of childhood injury prevention, guiding principles of injury prevention, successful strategies for prevention, and future directions., Result and Conclusion: Through surveillance, evidence-based injury prevention initiatives, and multi-disciplinary collaboration, we anticipate further reduction in childhood injuries., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.)

Objective: Although the Abbreviated Injury Scale (AIS) was initially developed in the mid-1960s for tracking injury in automotive and aircraft crashes, it has grown to become an internationally recognized scoring system for a variety of traumatic injuries. This shift in focus and advances in organized medical care, combined with feedback from field use and outcome analysis, have resulted in several AIS updates and revisions. This article demonstrates how AIS codes and severities have changed over the last 25 years and investigates the effects of those changes., Methods: Data from each version and update of the AIS dictionary (AIS 1990, AIS 1998, AIS 2005, AIS 2008, and AIS 2015) were analyzed for changes and shifts in injury descriptions, severities, and code counts., Results: The number of AIS codes has increased to improve coding specificity and reliability for a growing number of injury types. There has also been a shift in severities, mainly within the moderate (AIS 2) to severe (AIS 4) range. AIS 1990 was the first version to utilize the 6-digit predot identifier, to add modifiers for pediatric injury, and to substantially expand brain injury codes. AIS 1998 added coding rules and guidelines throughout the dictionary and integrated the Organ Injury Scale scores. The AIS 2005 dictionary added over 400 codes and made significant changes throughout. Fewer changes were made in the AIS 2008 update. AIS 2015 includes descriptions for tissue injuries with loss of soft tissue that do not qualify as amputations, a need identified in military injury analysis., Conclusions: Each updated version of AIS reflects improving medical care and new advances in understanding, measuring, and documenting injury. AIS changes over time reflect its international and cross-domain utilization for describing injury severity and set the standard for how the world now studies traumatic injury.

Battle-related mass burials are considered the most unequivocal evidence of past violence. However, most published studies involve only macroscopic analysis of skeletal remains, commonly arriving only at broad conclusions regarding trauma interpretation. The current study considers a possible avenue for achieving both greater detail and accuracy through digital microscopy. Patterns of injury were investigated among 45 individuals from a Medieval Danish mass grave (Sandbjerget, AD 1300-1350). Injuries were recorded on every anatomical element, except hand and foot bones. Each was photographed and cast, facilitating remote evaluations. Macroscopic analysis was compared with digital microscopy in order to test the relative utility of the latter in characterizing skeletal injuries (mechanism, weapon class, direction, timing of injury). The location of 201 observed injuries, mainly sharp force defects, suggested that many lesions were probably not inflicted by face-to-face opponents. Some microscopic features were indicative of a specific lesion type and weapon class. Digital microscopy was therefore demonstrated to be a complementary tool to macroscopic assessment, enhancing feature observation and quantification and serving to compensate for many of the limitations of macroscopic assessment., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Trauma is the leading cause of death among patients 46 years or younger, and having a system in place for the care of the injured is of paramount importance to the health of a community. The growth and development of civilian trauma systems has not been an easy process. The concept of regionalized health care that the trauma system models has been emulated by other specialized and time-sensitive areas of medicine, notably stroke and acute cardiac events. Continued process improvement, public education, support and involvement, a sound infrastructure, and integrated technology should remain our focus., (Copyright © 2017 Elsevier Inc. All rights reserved.)

The study of ante-mortem trauma is a popular and important aspect of palaeopathological analysis. The majority of publications focus on a particular assemblage, skeletal element or type of fracture, with case studies of single individuals with multiple/unusual traumata being much rarer in the literature. This paper presents the case of an adult male from the Bronze Age site of Sharakhalsun, Russia, buried, uniquely, in a sitting position on a fully assembled wagon, who displayed evidence for multiple healed ante-mortem fractures of the cranium, axial and appendicular skeleton. The mechanisms and likely etiologies of the fractures are presented, with reference to modern and 19th century clinical literature, and possible interpretations suggested: that the individual was involved in a severe accident involving a wagon or draft animals, or both, a number of years before his death. The suggestion is also made that the unique burial position of the individual was a form of commemoration by the community of the survival and recovery of the individual from such a serious incident., (Copyright © 2017 Elsevier GmbH. All rights reserved.)

Homer's Iliad is one of the highest intellectual products of the early ancient Greek civilisation. A plethora of medical information lies within Iliad's 24 rhapsodies, and a total of 147 injuries are described. The present study records and evaluates all cases of trauma management included in this epic poem. Not only Iliad's original text but also all myths related to Iliad from the five-volume Greek Mythology by Ioannis Kakridis were meticulously studied to locate the injured person, the type of trauma, the care provider and the type of given care as well as the outcome of each case. A total of 21 cases were found and evaluated with a 5% mortality rate. The majority of these injuries were caused by an arrow (43%) and were located to the upper extremity (43%). Injuries of the head, neck and trunk were not treated as all of them were lethal. Many of the recorded trauma management techniques can be correlated to modern medicine. Furthermore, the role and skills of military doctors and paramedics, mentioned by Homer, is discussed., (© 2016 Medicalhelplines.com Inc and John Wiley & Sons Ltd.)

The past 25 years have seen an increase in use of maggot therapy for wound care. Maggot therapy is very effective in wound debridement; it is simple to apply and requires very little in the way of resources, costs, or skilled personnel. These characteristics make it well suited for use in austere environments. The use of medical-grade maggots makes maggot therapy nearly risk free, but medical grade maggots may not always be available, especially in the wilderness or in resource-limited communities. By understanding myiasis and fly biology, it should be possible even for the nonentomologist to obtain maggots from the wild and apply them therapeutically, with minimal risks., (2017.)

Objective: To review the history of the innovation of damage control (DC) for management of trauma patients., Background: DC is an important development in trauma care that provides a valuable case study in surgical innovation., Methods: We searched bibliographic databases (1950-2015), conference abstracts (2009-2013), Web sites, textbooks, and bibliographies for articles relating to trauma DC. The innovation of DC was then classified according to the Innovation, Development, Exploration, Assessment, and Long-term study model of surgical innovation., Results: The "innovation" of DC originated from the use of therapeutic liver packing, a practice that had previously been abandoned after World War II because of adverse events. It then "developed" into abbreviated laparotomy using "rapid conservative operative techniques." Subsequent "exploration" resulted in the application of DC to increasingly complex abdominal injuries and thoracic, peripheral vascular, and orthopedic injuries. Increasing use of DC laparotomy was followed by growing reports of postinjury abdominal compartment syndrome and prophylactic use of the open abdomen to prevent intra-abdominal hypertension after DC laparotomy. By the year 2000, DC surgery had been widely adopted and was recommended for use in surgical journals, textbooks, and teaching courses ("assessment" stage of innovation). "Long-term study" of DC is raising questions about whether the procedure should be used more selectively in the context of improving resuscitation practices., Conclusions: The history of the innovation of DC illustrates how a previously abandoned surgical technique was adapted and readopted in response to an increased understanding of trauma patient physiology and changing injury patterns and trauma resuscitation practices.

In Article 30 of Wu shi er bing fang ( Prescriptions for Fifty - two Diseases ) , the " Qu ()" in " Shen Shen Er Bu Neng Qu ()" has an opposite relation with " Shen ()" , that is, " Shen ()" , and it should be interpreted as " Qu ()" , that is bend. Thus, in " Shen Shen Er Bu Neng Qu ()" , bodies that appear to have " Shang Jing ()" (spasmodic disease), causing stiffness and unable to flex. In Article 308 of Wu shi er bing fang, " Xi Xi Chu Chu ()" and " Xi Xi Chu Chu ()" are synonymous. The " Chu ()" in " Xi Xi Chu Chu ()" is interpreted as "(exit)" while " Xi Xi Chu Chu ()" depicts a curse in which an evil fire is summoned out of an oven. Therefore, the character "□" in the title of the text "□" should be considered to be the character for "(fire)" . Meanwhile, due to the wounds in the battle field, ancient people emphasized " Heng ()" . In other words, as the shin is an often site in battle wounds, it explains why " Heng Shang ()" is added after the title " Heng Liao ()" . Similarly, the " Heng Shang ()" battle wound, the text of the Mawangdui depicts the running course of Meridian in the lower extremity, while the much used expression of " Ji ()" is related to captives of war. This association is suggested to have been derived from "the use of leg shackles" .

In this perspective paper, we discuss clinical and biomechanical viewpoints on pressure injury (or pressure ulcer) prevention research. We have selected to focus on the case of prophylactic dressings for pressure injury prevention, and the background of the historical context of pressure injury research, as an exemplar to illuminate some of the good and not so good in current biomechanical and clinical research in the wound prevention and care arena. Investigators who are conducting medical or clinical research in academia, in medical settings or in industry to determine the efficacy of wound prevention and care products could benefit from applying some basic principles that are detailed in this paper, and that should leverage the research outcomes, thereby contributing to setting higher standards in the field., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

The Injury Free Coalition for Kids Annual Conference has contributed to the dissemination of information pertaining to the development of the field of injury prevention. A content analysis was completed using conference agendas used during the span of 2005-2015, finding that more than 398 presentations covering a wide variety of injuries have taken place. Published work has appeared in the Journal of Trauma and there has been recognition of people who have contributed to the development of the field. Forging New Frontiers is a valuable tool for attendees to exchange information about injury prevention.

In May 1875, in the midst of a bloody civil conflict in Spain known as the Third Carlist War, Nicasio Landa, a medical officer with Military Health, wrote a report requesting authorization for the Spanish Red Cross, of which he was Inspector General, to adopt a new elastic suspension system for stretchers that he had designed, developed and tested. Intended above all for use in farm wagons - still the most widely-used method of transporting the wounded at the time - it was an inexpensive, sturdy mechanism that improved patient comfort and could also be installed in ambulance carriages, railway carriages and hospital ships. An annotated version of the report is included, preceded by a presentation of its contents.

Background: Homer's detailed descriptions of head injuries inflicted during the Trojan War are of particular interest to individuals in the medical community. Although studies have examined the prevalence of such injuries, none have examined the preventive measures taken to avoid them. An in-depth review of helmet use in Homer's Iliad was conducted to address this previously unexplored facet of the epic., Methods: An English translation of Homer's text was reviewed for all references to helmet use. The number of helmet references in each book was recorded, along with other pertinent details for each reference., Results: There were 87 references to helmets (40 combat, 47 noncombat). The helmet belonged to a Greek warrior in 41 cases (47.1%), a Trojan warrior in 38 cases (43.6%), a divinity in 5 cases (5.7%), and a general group of warriors in 3 cases (3.4%). Helmet use provided protective benefit to Greek warriors at a rate of 30.0% (3 of 10) and Trojan warriors at a rate of 11.1% (2 of 18). This difference was not statistically significant (P = 0.23). The overall combined protective benefit of helmet use in the text was 17.9% (5 of 28). Helmets belonging to 15 specific Greek warriors and 18 specific Trojan warriors were referenced in the text. Helmets belonging to Hector (n = 12) and Achilles (n = 8) were most frequently mentioned., Conclusions: Helmet use and head injury both play a prominent role in Homer's Iliad. Helmets are frequently used in combat settings but with relatively little success. Helmets are also used in various noncombat settings., (Copyright © 2016 Elsevier Inc. All rights reserved.)