Acute Care Surgery And Trauma Evidence Based Practice pdf

  Ac ute C a re Surg e ry a nd Tra um a Evide nc e Ba se d Pra c tic e Ed ite d b y

  Acute Care Surgery and Trauma:

Evidence Based Practice

  

Edited by

MD FACS

  Stephen M. Cohn Witten B. Russ Professor of Surgery

University of Texas Health Science Center

San Antonio, Texas, USA

  © 2009 Informa UK Ltd

First published in the United Kingdom in 2009 by Informa Healthcare, Telephone House, 69-77 Paul Street, London EC2A 4LQ.

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  Contents

Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . viii

Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiv

Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvii

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxi

Section I – Trauma

  1. Evidence for Injury Prevention Strategies: From Private Practice to Public Policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Michelle A. Price and Cynthia L.Villarreal

  

2. Trauma Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

S. Morad Hameed and Richard K. Simons

  3. Evidence-Based Review of Trauma Outcomes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Michael M. Badellino, John J. Hong, and Michael D. Pasquale

  

4. Evidence-Based Surgery: Military Injury Outcomes . . . . . . . . . . . . . . . . . . . . . 23

Brian J. Eastridge

  

5. Evidence-Based Surgery: Traumatized Airway . . . . . . . . . . . . . . . . . . . . . . . . . . 29

Edgar J. Pierre and Amanda Saab

  

6. Monitoring of the Trauma Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

Eugene Y. Fukudome and Marc A. de Moya

  

7. Resuscitation of the Trauma Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

David R. King

  

8. Diagnosis of Injury in the Trauma Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

Pedro G. R. Teixeira and Kenji Inaba

  9. An Evidence-Based Approach to Damage Control Laparotomy for Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 Bruce Crookes

  

10. Evidence-Based Surgery: Coagulopathy in the Trauma Patient . . . . . . . . . . 65

Joseph J. DuBose and Peter M. Rhee

  

11. Traumatic Brain Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72

Ara J. Feinstein and Kenneth D. Stahl

  

12. Spine and Spinal Cord Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80 Yoram Klein and Shaul Sagiv iv Contents

  Facial Injuries

13. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86

  Antonio Jorge V. Forte, Renato da Silva Freitas and Joseph H. Shin Ocular Trauma: An Evidence-Based

14. Approach to Evaluation and Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92

  

15. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97

Marc A. de Moya Emergency Thoracotomy

  

26. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160

Joseph E. Glaser and Alexandra A. MacLean An Evidence-Based Approach to Pregnant Trauma Patients 27.

   . . . . . . . . . . . . . . . . . . 207 Steven E. Wolf

  

32. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199

Gabriel E. Burkhardt and Todd E. Rasmussen Critical Questions in Support of the Burned Patient 33.

  

31. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 194

Hany Bahouth and Doron Norman Limb Salvage for the Mangled Extremity

  

30. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186

Howard Wang, Patrick Schaner and Sahar David Lower Extremity Injury

   . . . . . . . . . . . 177 Terence O’Keeffe Surgery of Upper Extremity

  

28. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172

Matthew O. Dolich An Evidence-Based Approach to Extremity Vascular Trauma 29.

   . . . . . . . . . . . . 165 Igor Jeroukhimov Pelvic Fractures

  

25. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153

Adrian W. Ong and Elan Jeremitsky Abdominal Vascular Trauma

  

16. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102

Joseph J. DuBose and Mark Gunst Trauma to the Chest Wall

  Heidi I. Becker and M. Kelly Green Neck Trauma

  

23. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144

Daniel L. Dent Diaphragmatic Injuries

  

22. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138

Alberto Garcia, Maria Fernanda Jimenez and Juan Carlos Puyana Small Bowel and Colon Injuries

   . . . . . . . . . . . . . . . . . . . . . . 125 Deborah L. Mueller An Evidence-Based Approach to Spleen Trauma: Management 21. and Outcomes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131 Anne Saladyga and Robert Benjamin Injury to the Liver

  

19. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121

Dror Soffer and Edan Sarid Injury to the Esophagus, Trachea, and Bronchus 20.

   . . . . . . . . . . 115 Mark Cockburn Evidence-Based Surgery: Cardiac Trauma

  

17. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105

Joseph J. DuBose and Lydia Lam Evidence-Based Surgery: Injury to the Thoracic Great Vessels 18.

  

24. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147

Fahim Habib Pancreatic and Duodenal Trauma

  Contents v Burn Wound Management 34. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 212 Joseph H. Shin, Antonio Jorge V. Forte and Renato Freitas Inhalation Injury 35. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 218 Leopoldo C. Cancio Electrical, Cold, and Chemical Injuries 36. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 226 Stephanie A. Savage Evidence-Based Wound Care Management 37.

   . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233 David Sahar and Howard Wang Viperidae Snakebite Envenomation 38. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 240 Steven Granger and Ronald Stewart Evidence-Based Surgery: War Wounds 39. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245 Lorne H. Blackbourne Evidence-Based Surgery: Pediatric Trauma 40.

   . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250 Gerald Gollin An Evidence-Based Approach to Geriatric Trauma 41.

   . . . . . . . . . . . . . . . . . . . . 258 Carl I. Schulman Rural Trauma 42. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265 Burke Thompson Reducing Patient Errors in Trauma Care 43. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 268 Kenneth D. Stahl and Susan E. Brien

Section II – Emergency General Surgery Small Bowel Surgery 44. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 278

  Erik J. Teicher, John J. Hong, Michael M. Badellino, and Michael D. Pasquale An Evidence-Based Approach to Upper GI Bleed Management 45.

   . . . . . . . . 285 John G. Schneider and Bruce A. Crookes Peptic Ulcer Disease 46. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 290 Wayne H. Schwesinger Enterocutaneous Fistula 47. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 299 Peter A. Learn Paraesophageal Hernia Repair 48. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 303 Omid Noormohammadi, Alicia Logue and Kent R. Van Sickle Appendicitis 49. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 307 Peter P. Lopez and Amy De Rosa Lower Gastrointestinal Bleeding 50. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 316 Steven D. Schwaitzberg Diverticular Disease of the Colon 51. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 322 Brent Izu and Akpofure Peter Ekeh Large Bowel Obstruction 52. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 327 Jerry Lee Howard, John J. Hong, Michael M. Badellino, and Michael D. Pasquale Acute and Chronic Mesenteric Ischemia 53. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 333 Joshua B. Alley vi Contents

  Ogilvie’s Syndrome and Colonic Volvulus 54.

  

66. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 419

Ryan T. Hagino Ruptured Abdominal Aortic Aneurysm

  

74. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 457

Sapoora Manshaii and Greg J. Beilman

  

73. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 451

Christopher Busken, Rebecca Coefield, Robert Kelly and Steven Brower

  

72. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 447

Steven Schwaitzberg Surgical Endocrine Emergencies

  

71. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 443

Mark D. Sawyer Incarcerated Hernias

  

70. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 438

George C. Velmahos Necrotizing Soft Tissue Infections

  Paula K. Shireman Pulmonary Embolism

  Deep Venous Thrombosis

69. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 433

  

68. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 427

  

67. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 423

Boulos Toursarkissian Acute Aortic Dissection

  

65. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 415

Maureen K. Sheehan Acute Arterial Embolus

   . . . . . . . . . . . . . . . . . . . . . . . . . . . 336 Raymond P. Compton Hemorrhoids

   . . . . . 406 Robert M. Esterl Jr., Greg A. Abrahamian and K. Vincent Speeg Gangrene of the Foot

  

63. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 397

Andreas G. Tzakis and Pararas Nikolaos Diagnosis and Treatment of Variceal Hemorrhage due to Cirrhosis 64.

  

62. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 390

Olga N. Tucker and Raul J. Rosenthal Liver Abscess

  

61. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 382

Stephen W. Behrman Pancreatic Pseudo-cysts

  

60. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 374

Adrian W. Ong and Charles F. Cobb Acute Pancreatitis

   . . . . . . . . . . . . . . . . . . . . . . . . . . 368 Juliane Bingener Acute Cholangitis

   . . . . . . . . . . . . . . . . . . . . . . . . . . . 356 Scott R. Steele and Joel E. Goldberg Evidence-Based Practice: Acute Cholecystitis 59.

   . . . . . . . . . . . . . . . . . . . . . . . . . . . 348 Matthew J. Eckert, Joel E. Goldberg and Scott R. Steele Rectal Prolapse: Evidence-Based Outcomes 58.

  

56. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 345

W. Brian Perry Evidence-Based Surgery: Pilonidal Disease 57.

  

55. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 341

Clarence E. Clark III Anal Fissure, Fistula, and Abscess

V. Seenu Reddy

Section III – Surgical Critical Care Problems Evidence-Based Surgery: Bacteremia

  Contents vii

  75. Prevention of Central Venous Catheter Infections . . . . . . . . . . . . . . . . . . . . . 463 J. Matthias Walz and Stephen O. Heard

  76. Ventilator-Associated Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 467 Aaron M. Fields

  77. Management of Acute Myocardial Infarction and Cardiogenic Shock . . . 473 Antonio Hernandez

  78. Perioperative Arrhythmias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 480 Bipin K. Ravindran and Mohan N. Viswanathan

  79. Feeds and Feeding Surgical Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 486 Jayson D. Aydelotte

  80. Evidence-Based Surgery: Acute Lung Injury/Acute Respiratory Distress Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 490 Juan J. Blondet and Greg J. Beilman

  81. Acute Renal Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 497 Teofilo Lama

  82. Hyperglycemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 503 Balachundhar Subramaniam and Alan Lisbon

  83. Abdominal Compartment Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 509 James C. Doherty

  84. Agitation and Delirium in the ICU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 514 Robert Chen

  85. Malignant Hypertension: An Evidence-based Surgery Review . . . . . . . . . . 523 David S. Owens and Marshall A. Corson Appendix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 533

  Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 573

1 Contributors

  Wilford Hall Medical Center, Lackland AFB San Antonio, Texas, USA

  Juliane Bingener MD

  Department of Surgery, Mayo Clinic Rochester, Minnesota, USA

  COL Lorne H. Blackbourne MD FACS

  U.S. Army Institute of Surgical Research Fort Sam Houston San Antonio, Texas, USA

  Juan J. Blondet MD

  Postdoctoral Fellow, Department of Surgery University of Minnesota Minneapolis, Minnesota, USA

  Col. W. Brian Perry MD USAF MC

  Susan E. Brien MD MEd CSPQ FRCSC CPE

  Bethesda MD

  Associate Director, Professional Affairs, Royal College of Physicians and Surgeons of Canada Ottawa, Ontario, Canada

  Steven Brower MD

  Division of General Surgery Memorial Health Medical Center Savannah, Georgia, USA

  Gabriel E. Burkhardt MD Capt USAF MC

  Vascular Surgery Resident, Wilford Hall United States Air Force Medical Center, Lackland Air Force Base The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA

  Christopher Busken MD

  Division of General Surgery Memorial Health Medical Center Savannah, Georgia, USA

  Department of Surgery Madigan Army Medical Center, Tacoma Fort Lewis, Washington, USA

  Greg A. Abrahamian MD

  Assistant Professor of Surgery, Department of Surgery Transplant Center, University of Texas Health Science Center at San Antonio, Texas, USA

  Associate Professor of Surgery Penn State College of Medicine Program Director, General Surgery Residency Lehigh Valley Health Network Allentown, Pennsylvania, USA

  Omid Noormohammadi, Alicia Logue MD

  University of Texas Health Science Center San Antonio, Texas, USA

  Joshua B. Alley MD

  Major USAF MC, Staff General Surgeon Wilford Hall Medical Center, Lackland AFB Texas. Clinical Assistant Professor, Department of Surgery, University of Texas Health Science Center San Antonio, Texas, USA

  Jayson D. Aydelotte MD

  Director of Trauma, Department of Surgery Walter Reed Army Medical Center Washington, DC, USA

  Michael M. Badellino MD

  Hany Bahouth MD BS C

  Robert Benjamin MD FACS

  General and Trauma Surgeon, Director Acute Care Surgery, Rambam Health Campus Haifa, Israel

  Heidi I. Becker MD

  Assistant Professor Department of Ophthalmology, University of Texas Health Science Center at San Antonio San Antonio, Texas, USA

  Stephen W. Behrman MD FACS

  Associate Professor of Surgery, Department of Surgery The University of Tennessee Health Science-Center Memphis, Tennessee, USA

  Greg J. Beilman MD FACS

  Professor of Surgery, Department of Surgery University of Minnesota Minneapolis, Minnesota, USA

  Chief of Trauma Services William Beaumont Army Medical Center Department of Surgery El Paso, Texas, USA

  Contributors ix Leopoldo C. Cancio MD FACS

  Akpofure Peter Ekeh MD

  Matthew O. Dolich MD FACS

  Associate Clinical Professor, Department of Surgery University of California, Irvine Orange, California, USA

  Joseph J. DuBose MD

  Division of Acute Care Surgery, Trauma and Surgical Critical Care, Wilford Hall Medical Center Lackland AFB, Texas Clinical Instructor, Trauma and Surgical Critical Care Division of Trauma and Surgical Critical Care Los Angeles County, University of Southern California Hospital Los Angeles, California, USA

  COL Brian J. Eastridge MD FACS

  Director, Joint Trauma System U.S. Army Institute of Surgical Research Fort Sam Houston, San Antonio, Texas, USA

  Matthew J. Eckert MD

  Department of Surgery, Madigan Army Medical Center Fort Lewis, Washington, USA

  Associate Professor Wright State University Department of Surgery, Boonshoft School of Medicine Dayton, Ohio, USA Robert M. Esterl Jr.

  James C. Doherty MD MPH

  MD

  Professor of Surgery, Department of Surgery Transplant Center, University of Texas Health Science Center at San Antonio, Texas, USA

  Ara J. Feinstein MD MPH

  Ryder Trauma Center, Jackson Memorial Hospital Division of Trauma and Surgical Critical Care DeWitt Daughtry Family Department of Surgery Miami, Florida, USA

  Aaron M. Fields MD

  Assistant Program Director Critical Care Fellowship, Staff Intensivist Staff Anesthesiologist, United States Air Force Wilford Hall Medical Center Lackland AFB, Texas, USA

  Antonio Jorge V. Forte MD Resident

  Plastic Surgery, Section of Plastic Surgery Department of Surgery Yale University School of Medicine New Haven, Connecticut, USA

  Renato Freitas MD PhD

  Director of Trauma Surgery and Critical Care Advocate Christ Medical Center Oak Lawn, Illinois Clinical Assistant Professor of Surgery, University of Illinois College of Medicine, Chicago, Illinois, USA

  Associate Professor, Division of Trauma and Emergency Surgery, University of Texas Health Science Center San Antonio, Texas, USA

  Colonel, Medical Corps, U.S. Army, U.S., Army Institute of Surgical Research, Fort Sam Houston San Antonio, Texas, USA

  Division of General Surgery Memorial Health Medical Center Savannah, Georgia, USA

  Robert Chen MD FRCPC

  Attending Anaesthetist and Intensivist Assistant Professor St. Michael’s Hospital, Department of Anaesthesia University of Toronto, Toronto, Canada, USA

  Clarence E. Clark III MD

  Chief Resident, General Surgery Department of Surgery University of Texas Health Science Center San Antonio and Wilford Hall Medical Center San Antonio, Texas, USA

  Charles F. Cobb MD

  Associate Professor of Surgery, Drexel University College of Medicine, Allegheny General Hospital Department of Surgery Pittsburgh, Pennsylvania, USA

  Mark Cockburn MD

  New Rochelle, New York, USA

  Rebecca Coefi eld MD

  Raymond P. Compton MD FACS

  Daniel L. Dent MD

  Paris Surgical Specialists, Chief of Surgery, Henry County Medical Center Paris, Tennessee, USA

  Marshall A. Corson MD

  Associate Professor of Medicine Head, Section of Cardiology Medical Center Division of Cardiology University of Washington Medical Center Seattle, Washington, USA

  Bruce A. Crookes MD FACS

  Assistant Professor of Surgery, Division of Trauma Burns and Critical Care, Department of Surgery University of Vermont College of Medicine Burlington, Vermont, USA

  Marc A. de Moya MD FACS

  Assistant Professor of Surgery Harvard Medical School Division of Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital Boston, Massachusetts, USA

  Amy P. De Rosa DO

  Resident Surgeon MCRMC: Department of General Surgery Michigan State University East Larsing, Michigan, USA

  Adjunct Professor of Plastic Surgery Federal University of Parana Curitiba, Brazil x Contributors

  Eugene Y. Fukudome MD

  Resident in Surgery Wright State University Department of Surgery Boonshoft School of Medicine Dayton, Ohio, USA

  Assistant Professor Director of Cardiothoracic & Transplant Anesthesiology Department of Anesthesiology University of Texas Health Science Center San Antonio, Texas, USA

  John J. Hong MD

  Chief, Section of Trauma Research Division of Trauma/Surgical Critical Care Lehigh Valley Health Network Allentown, Pennsylvania , USA

  Jerry Lee Howard MD

  Department of Surgery, Lehigh Valley Health Network Allentown, Pennsylvania, USA

  Kenji Inaba MD MS C FRCSC FACS

  Assistant Professor of Surgery University of Southern California Division of Trauma Surgery and Surgical Critical Care Los Angeles, California, USA

  Brent Izu MD

  Elan Jeremitsky MD

  Professor, Departments of Anesthesiology and Surgery University of Massachusetts Medical School Worcester, Masschusetts, USA

  Division of Trauma Surgery Department of Surgery Allegheny General Hospital Pittsburgh, Pennsylvania, USA

  Igor Jeroukhimov MD

  Head of Trauma Unit Attending in General Surgery Division of Surgery, Hasaf Harofei Medical Center Affi liated with Tel Aviv University Zerefi n, Israel

  Maria Fernanda Jimenez MD

  Assistant Professor of Surgery, Javeriana University, Bogota, Colombia

  Robert Kelly MD

  Division of General Surgery, Memorial Health Medical Center Savannah, Georgia, USA

  David R. King MD Major USAF MC

  Antonio Hernandez MD

  Stephen O. Heard MD

  Resident, Department of Surgery Massachusetts General Hospital Boston, Massachusetts, USA

  Steven Granger MD

  Alberto Garcia MD

  Assistant Professor of Surgery, Universidad del Valle Chief Emergency Department, Fundacion Valle de Lili Cali, Colombia

  Joseph E. Glaser MD

  Resident, Department of General Surgery New York Hospital of Queens, Flushing New York, USA

  Joel E. Goldberg MD FACS

  Assistant Professor of Surgery, Brigham and Women’s Hospital Boston, Masschusetts, USA

  Gerald Gollin MD

  Associate Professor of Surgery and Pediatrics Loma Linda University School of Medicine Division of Pediatric Surgery Loma Linda, California, USA

  Department of Surgery Intermountain Medical Center Salt Lake City, Utah, USA

  Assistant Professor of Surgery and Critical Care Medicine, University of British Columbia Vancouver, Canada

  M. Kelly Green MD

  Resident, Department of Ophthalmology University of Texas Health Science Center at San Antonio San Antonio, Texas, USA

  Mark Gunst MD MPH

  Division of Acute Care Surgery Trauma and Surgical Critical Care Wilford Hall Medical Center Lackland AFB, Texas, USA

  Fahim Habib MD

  Assistant Professor of Surgery University of Miami, Miller School of Medicine Miami, Florida, USA

  Ryan T. Hagino MD FACS

  Associate Professor, Division of Vascular Surgery University of Texas Health Science Center San Antonio, Texas, USA

  S. Morad Hameed MD MPH FRCSC

  Instructor of Surgery, Division of Trauma Emergency Surgery, Surgical Critical Care Massachusetts General Hospital Harvard Medical School Boston, Massachusetts, USA

  Contributors xi Yoram Klein MD

  Michelle A. Price MEd PhD

  Adrian W. Ong MD

  Assistant Professor of Surgery Drexel University College of Medicine Allegheny General Hospital Department of Surgery Pittsburgh, Pennsylvania, USA

  Michael D. Pasquale MD

  Associate Professor of Surgery Penn State College of Medicine Chief, Division of Trauma/Surgical Critical Care Lehigh Valley Health Network Allentown, Pennsylvania, USA

  Edgar J. Pierre MD

  Assistant Professor of Anesthesiology Surgery and Care Critical Department of Anesthesiology, University of Miami Miami, Florida, USA

  Brad H. Pollock MPH PhD

  Professor and Chairman Department of Epidemiology and Biostatistics School of Medicine, University of Texas Health Science Center at San Antonio San Antonio, Texas, USA

  Assistant Professor of Surgery, University of Texas Health Science Center at San Antonio San Antonio, Texas, USA

  Terence O’Keeffe MB ChB BS C FRCS(E D ) MSPH

  Basil A. Pruitt, Jr., MD

  Clinical Professor Department of Surgery The University of Texas Health Science Center at San Antonio San Antonio, Texas, USA

  Juan Carlos Puyana MD

  Associate Professor Surgery and Critical Care Medicine University of Pittsburgh - Chief Medical Offi cer

  IMITS Center, UPMC Pittsburgh, Pennsylvania, USA

  Todd E. Rasmussen MD Lt Col USAF MC

  Chief Division of Surgery Wilford Hall USAF Medical Center Lackland Air Force Texas Associate Professor of Surgery, The Uniformed Services University of the Health Sciences Bethesda, Maryland, USA

  Bipin K. Ravindran MD MPH

  Division of Trauma, Critical Care and Emergency Surgery, Department of Surgery, University of Arizona Tucson, Arizona, USA

  Orthopedic Surgeon, Director, orthopedic surgery B Rambam Health Campus Haifa, Israel

  Assistant Professor of Surgery Chief, Division of Trauma and Emergency Surgery, The Hebrew University School of Medicine - Kaplan Medical Center Rehovot, Israel

  Peter P. Lopez MD

  Lydia Lam MD

  Critical Care Fellow, Division of Trauma and Surgical Critical Care, Los Angeles County University of Southern California Hospital Los Angeles, California, USA

  Teofi lo Lama MD

  Trauma and Critical Care Services Saint Mary’s Medical Center West Palm Beach, Florida, USA

  Peter A. Learn MD

  Clinical Assistant Professor of Surgery University of Texas Health Science Center San Antonio, Texas Wilford Hall, USAF Medical Center Lackland AFB, Texas, USA

  Alan Lisbon MD

  Associate Professor of Anaesthesia Harvard Medical School, Acting Chair, Anesthesia Critical Care and Pain Medicine Beth Israel Deaconess Medical Center Boston, Masschusetts, USA

  Assistant of Professor of Surgery Division of General and Laparoscopic Surgery University of Texas Health Science Center San Antonio, Texas, USA

  Doron Norman MD

  Alexandra A. MacLean MD

  Assistant Professor of Surgery, Weill Medical College Cornell University, Attending Surgeon New York Hospital of Queens Flushing, New York, USA

  Sapoora Manshaii MD

  Assistant Professor of Surgery Department of Surgery University of Minnesota Minneapolis, Minnesota, USA

  Deborah L. Mueller MD FACS

  Associate Professor of Surgery Division of Trauma and Emergency Surgery Department of Surgery, University of Texas Health Science Center San Antonio, Texas, USA

  Pararas Nikolaos MD PhD

  Transplant Institute, Miller School of Medicine University of Miami Miami, Florida , USA

  Fellow, Cardiology and Cardiac Electrophysiology Department of Medicine, Division of Cardiology University of Washington School of Medicine Seattle, Washington, USA xii Contributors

V. Seenu Reddy, MD MBA FACS

  Anne Saladyga MD

  Raul J. Rosenthal MD FACS

  The Bariatric Institute Cleveland Clinic Florida Weston, Florida, USA

  Amanda Saab MD

  Resident in Anesthesiology Department of Anesthesiology, University of Miami Miami, Florida, USA

  Shaul Sagiv MD

  Assistant Professor of Orthopedic Surgery, Chief Division of Spine and Orthopedic Trauma The Hebrew University School of Medicine – Kaplan Medical Center Rehovot, Israel

  David Sahar MD

  Division of Plastic and Reconstructive Surgery University of Texas Health Science Center San Antonio, Texas, USA

  William Beaumont Army Medical Center El Paso, Texas, USA

  Peter M. Rhee MD MPH

  Edan Sarid MD

  Research Assistant, The Yitzhak Robin Trauma Division Tel Aviv Sourasky Medical Center Department of Surgery B Tel Aviv, Israel

  Stephanie A. Savage MD Major USAF MC

  Surgical Critical Care/Chief of Trauma Wilford Hall Medical Center Lackland AFB, Texas, USA

  Mark D. Sawyer MD

  Consultant in Surgery Division of Trauma, Critical Care, and General Surgery, The Mayo Clinic Rochester, Minnesota, USA

  Patrick Schaner MD

  Division of Plastic and Reconstructive Surgery University of Texas Health Science Center San Antonio, Texas, USA

  Professor of Surgery, Chief, Section of Trauma Critical Care and Emergency Surgery Arizona Health Sciences Center Department of Surgery Tucson, Arizona, USA

  John G. Schneider MD

  Resident, Department of Surgery University of Vermont College of Medicine Burlington, Vermont, USA

  Joseph H. Shin MD FACS

  Carl I. Schulman MD MSPH FACS

  DeWitt Daughtry Family Department of Surgery Division of Trauma and Critical Care University of Miami Miller School of Medicine Miami, Florida, USA

  Steven D. Schwaitzberg MD

  Chief of Surgery, Cambridge Health Alliance Visiting Associate Professor Surgery Harvard Medical School Cambridge, Masschusetts, USA

  Wayne H. Schwesinger MD FACS

  Professor of Surgery Division of General and Laparoendoscopic Surgery Department of Surgery University of Texas Health Science Center San Antonio, Texas, USA

  Maureen K. Sheehan MD FACS

  Assistant Professor Division of Vascular Surgery University of Texas Health Science Center San Antonio, Texas, USA

  Chief of Plastic Surgery Department of Surgery, Baystate Medical Center Tufts Medical School Springfi eld, Masschusetts, USA

  Associate Professor of Surgery University of British Columbia Vancouver, Canada

  Joseph H. Shin MD FACS

  Chief of Plastic Surgery Department of Surgery, Baystate Medical Center Tufts Medical School Springfi eld, Masschusetts, USA

  Paula K. Shireman MD FACS

  Departments of Surgery and Medicine and The Sam and Ann Barshop Institute for Longevity and Aging Studies at the University of Texas Health Science Center South Texas Veterans Health Care System San Antonio, Texas, USA

  Kent R. Van Sickle MD

  Division of General and Laparoendoscopic Surgery University of Texas Health Science Center San Antonio, Texas, USA

  Renato da Silva Freitas MD PhD

  Adjunct Professor of Plastic Surgery Federal University of Parana Curitiba, Brazil

  Richard K. Simons MBChB FRCSC

  Assistant Professor Division of Thoracic Surgery Director Thoracic Aortic Surgery Department of Surgery University of Texas Health Science Center San Antonio, Texas, USA

  Contributors xiii Boulos Toursarkissian MD

  University of Texas Health Science Center San Antonio, Texas Clinical Instructor, Trauma Surgery San Antonio, Texas Institute of Surgical Research San Antonio, Texas, USA

  Professor of Medicine/Gastroenterology Transplant Center, University of Texas Health Science Center at San Antonio, Texas, USA

  Kenneth D. Stahl MD FACS

  Assistant Professor of Surgery and Director of Patient Safety, DeWitt Daughtry Family Department of Surgery, Division of Trauma and Surgical Critical Care, Director of Patient Safety Research William Lehman Injury Research Center The University of Miami Leonard M. Miller School of Medicine Miami, Florida, USA

  Scott R. Steele MD FACS

  Colon and Rectal Surgery, Madigan Army Medical Center Department of Surgery Assistant Professor of Surgery Uniformed Services University Fort Lewis, Washington, USA

  Ronald Stewart MD

  Balachundhar Subramaniam MBBS MD

  Director, The Yitzhak Rabin Trauma, Division Assistant Professor of Surgery, Tel Aviv Sourasky Medical Center, Department of Surgery B Tel Aviv, Israel

  Assistant Professor of Anaesthesia, Harvard Medical School, Director of Cardiac Anesthesia Research Beth Israel Deaconess Medical Center Boston, Masschusetts, USA

  Erik J. Teicher MD

  Division of Trauma/Surgical Critical Care Lehigh Valley Health Network Allentown, Pennsylvania, USA

  Pedro G.R. Teixeira MD

  Research Fellow University of Southern California Division of Trauma Surgery and Surgical Critical Care Los Angeles, California, USA

  Burke Thompson MD MPH

  K. Vincent Speeg MD PhD

  Dror Soffer MD

  Associate Professor and Chief Division of Vascular Surgery University of Texas Health Science Center San Antonio, Texas, USA

  Cynthia L. Villarreal MA

  Olga N. Tucker MD FRCSI

  The Academic Department of Surgery The Queen Elizabeth Hospital Birmingham, United Kingdom

  Andreas G. Tzakis MD PhD FACS

  Professor of Surgery Transplant Institute, Miller School of Medicine University of Miami Miami, Florida, USA

  George C. Velmahos MD PhD MSEd

  John F. Burke Professor of Surgery Harvard Medical School, Chief, Division of Trauma Emergency Surgery, and Surgical Critical Care Massachusetts General Hospital Boston, Massachusetts, USA

  Faculty Associate Department of Surgery University of Texas Health Science Center at San Antonio San Antonio, Texas, USA

  Betty and Bob Kelso Distinguished Professor in Burns and Trauma, Vice-Chairman for Research Department of Surgery, University of Texas Health Science Center Chief and Task Area Manager, Clinical Trials United States Army San Antonio, Texas, USA

  Mohan N. Viswanathan MD

  Assistant Professor of Medicine Division of Cardiology Section of Cardiac Electrophysiology Department of Medicine University of Washington School of Medicine Seattle, Washington, USA

  J. Matthias Walz MD

  Assistant Professor Departments of Anesthesiology and Surgery University of Massachusetts Medical School Worcester, Massachusetts, USA

  Howard Wang MD

  University of Texas Health Science Center San Antonio, Texas Division of Plastic and Reconstructive Surgery San Antonio, Texas, USA

  Steven E. Wolf MD

  Associate Director of Trauma Moses Cone Health System, Trauma Program Moses Cone Memorial Hospital Greensboro, North Carolina, USA

  

1

  “The questions never change . . . just the answers!”

  —Owen Wangensteen Preface

JOHN HUNTER, FATHER OF EVIDENCE-BASED SURGERY

  The first surgeon to apply evidence to the field of surgery was probably John Hunter (1728–1793, Fig. P.1). His approach to medicine is exemplified by his management of gunshot wounds.

  Conventional practice dictated that army surgeons open up a gunshot wound—a technique known as “dilatation”— prize out the musket ball or shot with their fingers or forceps prior to cleaning away any debris and dressing the wound. The principle of dilatation stemmed from the belief that gunpowder was poisonous, dating back to its first use in European warfare in the thirteenth century. This doctrine almost certainly increased death and suffering. The acts of incising flesh within a wound were exceedingly painful before the advent of anaesthetic agents and often lead to tremendous loss of blood. In addition, dilatation frequently introduced fatal infection as military surgeons often treated their casualties on muddy, manure-ridden battlefields.