ABSTRACT
Objective To explore the value of retrievable inferior vena cava (IVC) filter placement for prevention of perioperative pulmonary embolism (PE) in patients with lower extremity/pelvic fracture with deep vein thrombosis (DVT).Methods Clinical data of 1 891 lower extremity/pelvic fracture patients combined with DVT were retrospectively analyzed.Totally 411 patients with permanent filters were excluded,and the other patients were divided into filter group (n=843) and control group (n=637) according to whether receiving retrievable IVC filter placement or not.The incidence of perioperative symptomatic PE and mortality were compared between the two groups.Results In filter group,Optease nonpermanent filters were inserted in 218 patients,and the mean indwelling time was (14.3±3.6) days.Celcet filters were inserted in 625 patients,and the filters were successfully removed in 566 out of 578 patients who underwent filter removal surgery (97.92％,566/578),and the mean indwelling time was (15.8±4.1) days.The incidence of PE in filter group (0.12％[1/843]) was significantly lower than that in control group (1.57％ [10/637],P＜0.05).Among the patients who received chemical anticoagulant therapy,the incidence of PE in filter group and control group was 0.14 ％ (1/700) and 1.47％(9/612),respectively (P＜0.05).Conclusion Retrievable IVC filter placement is a safe and effective method for preventing perioperative symptomatic and fatal PE in lower extremity/pelvic fracture patients with DVT.
ABSTRACT
Pathohistological observations on the soft tissue wounds experimentally produced with steel-bullets of three different weights and 8 different velocities were carried out on 42 dogs. It was found that if the weight of the bullets was identi- cal while their velocities were different, the severity of the injury and the extent of the contusion zone were directly related to the velocity of the bullet. The characteristic feature was that the injury at the entrance of the bullet was more severe than that at the exit. It might be resulted from the fact that the energy of the bullet was rapidly delivered soon after it penetrated the skin because of its light weight and the high resistance of the tissues.
ABSTRACT
This article is to report the histological and ultrastructural changes after high-velocity steel bullet injury on the hind legs of 15 dogs. The degree and extent of the bullet wound were observed 6, 12. and 24 hours after injury.It was found that under either light or electron microscope, there was rather apparent damage of the tissues in the contusion zone and also various intensity of damage in both the internal and external layers of the concussion zone at the 6th hour after injury. At the 24th hour after injury, the intensity of damage is somewhat similar to that at the 6th hour except that the breaking down of the necrotic tissues and infiltration of inflammatory cells in the contusion zone were more marked and the degenerative and destructive changes of myofibrils and some or-ganells such as mitochondria were reduced in both the internal and external layers of the concussion zone. It was confirmed with electron microscopy that damage of tissues could be observed in the area 3 cm. from the wall of the wound tract. Most changes in the concussion zone were reversible with the lapse of time.