Penetrating neck wounds are potentially dangerous and require emergency management because of the presence of vital structures in the neck. Organic foreign bodies further carries a risk of wound infection. We present a case of penetrating broken branch of a tree traversing from zone II to zone III without any neurovascular injury. Neck exploration was done with midline mandibulotomy approach an...

A 55-year-old man with multiple pellet injuries was brought to the Emergency room. In his physical examination, there were multiple wounds in face, neck, shoulders, arms, thorax and upper abdomen. The therapeutic options include pericardial drainage, conservative treatment, and surgical removal of the pellet. But, he was successfully managed with conservative medical treatment. This case showed...

THE TREATM,ENT of gun-shot wounds constitutes a significant part of the work of an accident and emergency department in this area. A common problem is the through and through wound, which does not involve damage to vital structures, such as nerves or blood vessels. The purpose of this paper is to attempt to rationalise the treatment of such injuries, and to present a series of such cases treate...

For a select group of patients with penetrating chest trauma, immediate thoracotomy in the accident and emergency department offers the only chance of survival. Foley catheters have been used to achieve haemostasis in cardiac wounds but are not widely used for intracardiac fluid and drug administration during resuscitation. In an anatomical model designed to assess this procedure an average flo...

BACKGROUND Efforts to develop effective and regionally-appropriate emergency care systems in sub-Saharan Africa are hindered by a lack of data on both the burden of disease in the region and on the state of existing care delivery mechanisms. This study describes the burden of acute disease presenting to an emergency unit in Mahajanga, Madagascar. METHODS AND FINDINGS Handwritten patient regis...

OBJECTIVE The aim of this study was to determine the rate of infection at which it is cost-effective to treat dog bite wounds with antibiotics. METHODS Our study was composed of two parts. First we performed a randomized, double-blind controlled trial (RCT) to compare the infection rates of dog bite wounds in patients given amoxicillin-clavulanic acid versus placebo. Subjects were immunocompe...

A 21-year-old male was admitted to the emergency department with bleeding skin burns. He had been exposed to 70% hydrofluoric acid (HF) through his nitrile hand gloves during an etching glass procedure at work. He had painful lesions, which included bleeding skin abrasions due to seconddegree burns on the first and second fingertips on the right hand, and white spots on the left first finger, w...

Internal hemorrhaging is a leading cause of death after traumatic injury on the battlefield. Although several surgical approaches such as the use of fibrin glue and tissue adhesive have been commercialized to achieve hemostasis, these approaches are difficult to employ on the battlefield and cannot be used for incompressible wounds. Here, we present shear-thinning nanocomposite hydrogels compos...

LAST SPRING, A GROUP CALLED MAYors Against Illegal Guns, a coalition of US mayors who want more stringent regulation of firearm sales, unveiled a television commercial featuring clips from speeches by the 3 leading presidential candidates. In these clips, Sen Hillary Rodham Clinton (D, NY), Sen Barack Obama (D, Ill), and Sen John McCain (R, Ariz) said they oppose a “gun show loophole” that allo...

OBJECTIVE To determine if there is a significant difference in the infection rates of wounds irrigated with sterile normal saline (SS) versus tap water (TW), before primary wound closure. DESIGN Single centre, prospective, randomised, double-blind controlled trial. Wound irrigation solution type was computer randomised and allocation was done on a sequential basis. SETTING Stanford Universi...