Core Topics in General & Emergency Surgery: Companion to Specialist Surgical Practice (66 page)
Read Core Topics in General & Emergency Surgery: Companion to Specialist Surgical Practice Online
Authors: Simon Paterson-Brown MBBS MPhil MS FRCS
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Johnson, J.W., Gracias, V.H., Gupta, R., et al, Hepatic angiography in patients undergoing damage control laparotomy.
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Asensio, J.A., Roldan, G., Petrone, P., et al, Operative management and outcomes in 103 AAST-OIS grades IV and V complex hepatic injuries: trauma surgeons still need to operate, but angioembolization helps.
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Recommended reading
Boffard K.D., ed. Manual of definitive surgical trauma care, 3rd ed, London: Hodder Arnold, 2011.
Committee on Trauma of the American College of Surgeons.
Resources for optimal care of the trauma patient
. Chicago, IL: Committee on Trauma of the American College of Surgeons; 2006.
Peitzman A., Rhodes M., Schwab C.W., eds. The trauma manual: Trauma and acute care surgery. Philadelphia, PA: Lippincott, Williams & Wilkins, 2008.
Websites
Organ Injury Scaling of the American Association for the Surgery of Trauma.
Eastern Association for the Surgery of Trauma.
Practice Management Guidelines.
World Society of the Abdominal Compartment Syndrome (WSACS).
Scaling system for organ-specific injuries
Cervical vascular organ injury scale
Chest wall injury scale
Heart injury scale
Lung injury scale
Thoracic vascular injury scale
Diaphragm injury scale
Spleen injury scale
Liver injury scale
Extrahepatic biliary tree injury scale
Pancreas injury scale
Oesophagus injury scale
Stomach injury scale
Duodenum injury scale
Small-bowel injury scale
Colon injury scale
Rectum injury scale
Abdominal vascular injury scale
Adrenal organ injury scale
Kidney injury scale
Ureter injury scale
Bladder injury scale
Urethra injury scale
Uterus (non-pregnant) injury scale
Uterus (pregnant) injury scale
Fallopian tube injury scale
Ovary injury scale
Vagina injury scale
Vulva injury scale
Testis injury scale
Scrotum injury scale
Penis injury scale
Peripheral vascular organ injury scale
Table A1
Cervical vascular organ injury scale
*
Increase one grade for multiple grade III or IV injuries involving more than 50% vessel circumference. Decrease one grade for less than 25% vessel circumference disruption for grade IV or V.
Reproduced from Moore EE, Malangoni MA, Cogbill TH et al. Organ Injury Scaling VII: Cervical vascular, peripheral vascular, adrenal, penis, testis and scrotum. J Trauma 1996; 41(3):523–4. With permission from Lippincott, Williams & Wilkins.
Table A2
Chest wall injury scale
*
This scale is confined to the chest wall alone and does not reflect associated internal or abdominal injuries. Therefore, further delineation of upper versus lower or anterior versus posterior chest wall was not considered, and a grade VI was not warranted. Specifically, thoracic crush was not used as a descriptive term; instead, the geography and extent of fractures and soft tissue injury were used to define the grade. Upgrade by one grade for bilateral injuries.
Reproduced from Moore EE, Cogbill TH, Jurkovich GJ. Organ Injury Scaling III: chest wall, abdominal vascular, ureter, bladder and urethra. J Trauma 1992; 33:337–8. With permission from Lippincott, Williams & Wilkins.
Table A3
Heart injury scale
*
Advance one grade for multiple wounds to a single chamber or multiple chamber involvement.
Reproduced from Moore EE, Malangoni MA, Cogbill TH et al. Organ Injury Scaling IV: thoracic, vascular, lung, cardiac and diaphragm. J Trauma 1994; 36(3):299–300. With permission from Lippincott, Williams & Wilkins.
Table A4
Lung injury scale
*
Advance one grade for bilateral injuries up to grade III. Haemothorax is scored under thoracic vascular injury scale.
Reproduced from Moore EE, Malangoni MA, Cogbill TH et al. Organ Injury Scaling IV: thoracic, vascular, lung, cardiac and diaphragm. J Trauma 1994; 36(3):299–300. With permission from Lippincott, Williams & Wilkins.
Table A5
Thoracic vascular injury scale
*
Increase one grade for multiple grade III or IV injuries if more than 50% circumference. Decrease one grade for grade IV injuries if less than 25% circumference.
Reproduced from Moore EE, Malangoni MA, Cogbill TH et al. Organ Injury Scaling IV: thoracic, vascular, lung, cardiac and diaphragm. J Trauma 1994; 36(3):299–300. With permission from Lippincott, Williams & Wilkins.
Table A6
Diaphragm injury scale
*
Advance one grade for bilateral injuries up to grade III.
Reproduced from Moore EE, Malangoni MA, Cogbill TH et al. Organ Injury Scaling IV: thoracic, vascular, lung, cardiac and diaphragm. J Trauma 1994; 36(3):299–300. With permission from Lippincott, Williams & Wilkins.
Table A7
Spleen injury scale (1994 revision)
*
Advance one grade for multiple injuries up to grade III.
Reproduced from Moore EE, Cogbill TH, Jurkovich GJ et al. Organ Injury Scaling: spleen and liver (1994 revision). J Trauma 1995; 38(3):323–4. With permission from Lippincott, Williams & Wilkins.
Table A8
Liver injury scale (1994 revision)
*
Advance one grade for multiple injuries up to grade III.
Reproduced from Moore EE, Cogbill TH, Jurkovich GJ et al. Organ Injury Scaling: spleen and liver (1994 revision). J Trauma 1995; 38(3):323–4. With permission from Lippincott, Williams & Wilkins.
Table A9
Extrahepatic biliary tree injury scale
*
Advance one grade for multiple injuries up to grade III.
Reproduced from Moore EE, Jurkovich GJ, Knudson MM et al. Organ Injury Scaling VI: extrahepatic biliary, oesophagus, stomach, vulva, vagina, uterus (non-pregnant), uterus (pregnant), Fallopian tube, and ovary. J Trauma 1995; 39(6):1069–70. With permission from Lippincott, Williams & Wilkins.
