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Article ; Online: Important learning points arising from the focused issue dedicated to the Terror and Disaster Surgical Care (TDSC®) course on mass casualty incident management.

Ashkenazi, Itamar / Örtenwall, Per / Turégano Fuentes, Fernando

European journal of trauma and emergency surgery : official publication of the European Trauma Society

2021 Volume 48, Issue 5, Page(s) 3593–3597

Abstract: The Terror and Disaster Surgical Care (TDSC®) course on mass casualty incident management was formulated in Germany by military medical personnel, who have been deployed to conflict areas, but also work in hospitals open for the lay public. In this ... ...

Abstract	The Terror and Disaster Surgical Care (TDSC®) course on mass casualty incident management was formulated in Germany by military medical personnel, who have been deployed to conflict areas, but also work in hospitals open for the lay public. In this manuscript we discuss different concepts and ideas taught in this course as these are described in a focused issue recently published in the European Journal of Trauma and Emergency Surgery. We provide reinforcement for some of the ideas conveyed. We provide alternative views for others. Injuries following explosions are different from blunt and penetrating trauma and at times demand a different approach. There are probably several ways to manage a mass casualty incident depending on the setup of the organization. An open discussion on the topics presented in the manuscripts included in the focused issue on military and disaster surgery should enrich everyone.
MeSH term(s)	Disaster Planning ; Germany ; Humans ; Mass Casualty Incidents ; Triage
Language	English
Publishing date	2021-01-24
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	2275480-5
ISSN	1863-9941 ; 1863-9933
ISSN (online)	1863-9941
ISSN	1863-9933
DOI	10.1007/s00068-021-01600-8
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Article ; Online: Teaching courses in the management of visceral trauma.

Turégano Fuentes, Fernando / Pérez Díaz, Dolores

Cirugia espanola

2018 Volume 96, Issue 10, Page(s) 606–611

Abstract: Several changes introduced in the management of trauma during the last two decades have considerably decreased the practical exposure to bleeding trauma patients by residents and young surgeons. Hemorrhage still represents the second cause of death from ... ...

Title translation	Docencia en el manejo del traumatismo visceral.
Abstract	Several changes introduced in the management of trauma during the last two decades have considerably decreased the practical exposure to bleeding trauma patients by residents and young surgeons. Hemorrhage still represents the second cause of death from trauma worldwide, and the surgical maneuvers required for its control must be learned and practised in specific courses. These courses address the "second hour" of trauma, beyond ATLS
MeSH term(s)	Curriculum ; Education, Medical/methods ; General Surgery/education ; Humans ; Viscera/injuries ; Viscera/surgery
Language	Spanish
Publishing date	2018-10-26
Publishing country	Spain
Document type	Journal Article
ISSN	2173-5077
ISSN (online)	2173-5077
DOI	10.1016/j.ciresp.2018.09.007
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Article: Treatment Options in Gastrointestinal Cutaneous Fistulas.

Ashkenazi, Itamar / Turégano-Fuentes, Fernando / Olsha, Oded / Alfici, Ricardo

Surgery journal (New York, N.Y.)

2017 Volume 3, Issue 1, Page(s) e25–e31

Abstract: Enterocutaneous fistulas occur most commonly following surgery. A minority of them is caused by a myriad of other etiologies including infection, malignancy, and radiation. While some fistulas may close spontaneously, most patients will eventually need ... ...

Abstract	Enterocutaneous fistulas occur most commonly following surgery. A minority of them is caused by a myriad of other etiologies including infection, malignancy, and radiation. While some fistulas may close spontaneously, most patients will eventually need surgery to resolve this pathology. Successful treatment entails adoption of various methods of treatment aimed at control of sepsis, protection of surrounding skin and soft tissue, control of fistula output, and maintenance of nutrition, with eventual spontaneous or surgical closure of the fistula. The aim of this article is to review the various treatment options in their appropriate context.
Language	English
Publishing date	2017-03-14
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2864275-2
ISSN	2378-5136 ; 2378-5128
ISSN (online)	2378-5136
ISSN	2378-5128
DOI	10.1055/s-0037-1599273
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Article ; Online: Relationship between the anatomical location and the selective non-operative management of penetrating stab wounds in the abdomen.

Tudela Lerma, María / Turégano Fuentes, Fernando / Pérez Díaz, María Dolores / Rey Valcárcel, Cristina / Martín Román, Lorena / Ruiz Moreno, Cristina / Fernández Vázquez, María Luz / Fernández Martínez, María

Cirugia espanola

2022 Volume 100, Issue 2, Page(s) 67–73

Abstract: Introduction: The relationship between the anatomical location of penetrating abdominal stab wounds (SW) and the rate of selective non-operative management (SNOM) based on that location is scarcely reflected in the specialized literature. Our main ... ...

Abstract	Introduction: The relationship between the anatomical location of penetrating abdominal stab wounds (SW) and the rate of selective non-operative management (SNOM) based on that location is scarcely reflected in the specialized literature. Our main objective has been to assess this rate based on the anatomical location, and our results. Methods: Retrospective review of a prospective registry of abdominal trauma from April 1993 to June 2020. The two study groups considered were the Operative Management (OM), and the SNOM, including in this one the use of diagnostic laparoscopy. Penetrating SWs in the abdomen were classified according to anatomical location. Results: We identified 259 patients who fulfilled the inclusion criteria. SNOM was applied in 31% of the patients with a success rate of 96%, and it was more frequent in the lumbar, flank, and thoraco-abdominal regions; within the anterior abdomen it was more applicable in the RH, followed by the LH and epigastrium, respectively. An unnecessary laparotomy was done in 21% of patients, with the highest number in the epigastrium. Taking into account the unnecessary laparotomies and the rates of successful SNOM, 70.5% of lumbar, 66.5% of epigastric, 62% of flank, and 59% of RH penetrating SW could have been managed without a laparotomy. Conclusions: SNOM of penetrating SW in the abdomen has been safer and more applicable in those located in the lumbar, flank, epigastric, and RH regions.
Language	English
Publishing date	2022-02-02
Publishing country	Spain
Document type	Journal Article
ISSN	2173-5077
ISSN (online)	2173-5077
DOI	10.1016/j.cireng.2022.01.006
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Article ; Online: Boerhaave syndrome presenting as gastric emphysema.

Ciriano Hernández, Patricia / Grao Torrente, Irene / Viejo Martínez, Elena / Turégano Fuentes, Fernando

Cirugia espanola

2018 Volume 97, Issue 4, Page(s) 231

Title translation	Enfisema gástrico como presentación de síndrome de Boerhaave.
MeSH term(s)	Aged ; Emphysema/diagnostic imaging ; Emphysema/etiology ; Esophageal Perforation/diagnostic imaging ; Esophageal Perforation/surgery ; Gastritis/complications ; Gastritis/pathology ; Humans ; Laparotomy/methods ; Male ; Mediastinal Diseases/diagnostic imaging ; Mediastinal Diseases/surgery ; Rupture, Spontaneous/diagnostic imaging ; Treatment Outcome
Language	Spanish
Publishing date	2018-10-10
Publishing country	Spain
Document type	Case Reports ; Journal Article
ISSN	2173-5077
ISSN (online)	2173-5077
DOI	10.1016/j.ciresp.2018.08.013
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Article ; Online: Relationship between the anatomical location and the selective non-operative management of penetrating stab wounds in the abdomen.

Cirugia espanola

2021

Title translation	Relación entre la localización anatómica y el manejo selectivo no operatorio de las heridas por arma blanca penetrantes en abdomen.
Abstract	Introduction: The relationship between the anatomical location of penetrating abdominal stab wounds (SW) and the rate of selective non-operative management (SNOM) based on that location is scarcely reflected in the specialized literature. Our main objective has been to assess this rate based on the anatomical location, and our results. Methods: Retrospective review of a prospective registry of abdominal trauma from April 1993 to June 2020. The two study groups considered were the Operative Management (OM), and the SNOM, including in this one the use of diagnostic laparoscopy. Penetrating SWs in the abdomen were classified according to anatomical location. Results: We identified 259 patients who fulfilled the inclusion criteria. SNOM was applied in 31% of the patients with a success rate of 96%, and it was more frequent in the lumbar, flank, and thoraco-abdominal regions; within the anterior abdomen it was more applicable in the RUQ, followed by the LUQ and epigastrium, respectively. An unnecessary laparotomy was done in 21% of patients, with the highest number in the epigastrium. Taking into account the unnecessary laparotomies and the rates of successful SNOM, 70,5% of lumbar, el 66,5% of epigastric, 62% of flank, and 59% of RUQ penetrating SWs could have been managed without a laparotomy. Conclusions: SNOM of penetrating SWs in the abdomen has been safer and more applicable in those located in the lumbar, flank, epigastric, and RUQ regions.
Language	Spanish
Publishing date	2021-02-13
Publishing country	Spain
Document type	Journal Article
ISSN	2173-5077
ISSN (online)	2173-5077
DOI	10.1016/j.ciresp.2020.12.003
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Article ; Online: Ten years using the advanced triage model for out-of-hospital emergencies (META): the 2020 version.

Arcos González, Pedro / Castro Delgado, Rafael / Cuartas Álvarez, Tatiana / Garijo Gonzalo, Gracia / Martínez Monzón, Carlos / Peláez Corres, Nieves / Rodríguez Soler, Alberto / Romero Pareja, Rodolfo / Turégano Fuentes, Fernando

Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias

2021 Volume 33, Issue 5, Page(s) 387–391

Title translation	Diez años del Modelo Extrahospitalario de Triaje Avanzado (META): versión 2020.
MeSH term(s)	Emergencies ; Emergency Medical Services ; Emergency Service, Hospital ; Hospitals ; Humans ; Triage
Language	Spanish
Publishing date	2021-10-19
Publishing country	Spain
Document type	Journal Article
ZDB-ID	2127173-2
ISSN	2386-5857 ; 2386-5857
ISSN (online)	2386-5857
ISSN	2386-5857
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Article ; Online: Relevance of pneumoperitoneum in the conservative approach to complicated acute diverticulitis. A retrospective study identifying risk factors associated with treatment failure.

Martín-Román, Lorena / Fernández-Martínez, María / Kayser Mata, Silvia / Colombari, Renan / Pascual-Espinosa, Pablo / Rey-Valcárcel, Cristina / Jiménez-Gómez, Luis M / Turégano-Fuentes, Fernando

Minerva surgery

2021 Volume 77, Issue 4, Page(s) 327–334

Abstract: Background: The aim of this study is to evaluate the relevance of pneumoperitoneum on the success rate of non-operative management (NOM) of patients with complicated acute diverticulitis (AD), and the risk factors associated with failure.: Methods: ... ...

Abstract	Background: The aim of this study is to evaluate the relevance of pneumoperitoneum on the success rate of non-operative management (NOM) of patients with complicated acute diverticulitis (AD), and the risk factors associated with failure. Methods: Observational retrospective cohort study of patients attended at the emergency department for AD from January 2015-August 2019. Patient demographics, blood tests, radiological data and initial treatment strategies were registered. NOM, based on intravenous antibiotics (ATB) and bowel rest, was defined as unsuccessful when emergency surgery (ES) and/or infection-related death took place. Patients initially treated with ES were excluded. Analysis was done with the IBM SPSS statistics 23.0.0.2 software. Results: According to modified Hinchey and WSES criteria, 99 (12%) of 826 AD episodes were complicated, with pneumoperitoneum on the CT scan in 89 (90.5%). NOM was undertaken in 93 (94%) cases, with a 91.5% success rate. Multivariate analysis revealed ASA class III-IV, and the presence of fluid collections >3 cm in diameter, but not distant free air, to be associated with NOM failure. However, the success rate of NOM was significantly higher in patients with pericolic pneumoperitoneum (98.5%) than in those with distant free air (80%) (P=0.02). Risk factors of NOM failure were an advanced age, high CRP and WBC values, and the presence of free fluid in >2 abdominal quadrants. Conclusions: NOM in hemodynamically stable patients with complicated AD is a safe and feasible approach, even in the context of distant free air. Nevertheless, patients with isolated pericolic air did better in our series.
MeSH term(s)	Diverticulitis/therapy ; Humans ; Pneumoperitoneum/diagnostic imaging ; Retrospective Studies ; Risk Factors ; Treatment Failure
Language	English
Publishing date	2021-08-02
Publishing country	Italy
Document type	Journal Article ; Observational Study
ZDB-ID	3067899-7
ISSN	2724-5438
ISSN (online)	2724-5438
DOI	10.23736/S2724-5691.21.08997-8
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Article: Treatment Options in Gastrointestinal Cutaneous Fistulas

Ashkenazi, Itamar / Turégano-Fuentes, Fernando / Olsha, Oded / Alfici, Ricardo

The Surgery Journal

2017 Volume 03, Issue 01, Page(s) e25–e31

Abstract	Enterocutaneous fistulas occur most commonly following surgery. A minority of them is caused by a myriad of other etiologies including infection, malignancy, and radiation. While some fistulas may close spontaneously, most patients will eventually need surgery to resolve this pathology. Successful treatment entails adoption of various methods of treatment aimed at control of sepsis, protection of surrounding skin and soft tissue, control of fistula output, and maintenance of nutrition, with eventual spontaneous or surgical closure of the fistula. The aim of this article is to review the various treatment options in their appropriate context.
Keywords	fistula ; intestinal fistula ; enterocutaneous fistula
Language	English
Publishing date	2017-01-01
Publisher	Thieme Medical Publishers
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2864275-2
ISSN	2378-5136 ; 2378-5128
ISSN (online)	2378-5136
ISSN	2378-5128
DOI	10.1055/s-0037-1599273
Database	Thieme publisher's database

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Article ; Online: The Impact of Age upon Contingency Planning for Multiple-casualty Incidents Based on a Single Center's Experience.

Ashkenazi, Itamar / Einav, Sharon / Olsha, Oded / Turegano-Fuentes, Fernando / Krausz, Michael M / Alfici, Ricardo

Prehospital and disaster medicine

2016 Volume 31, Issue 5, Page(s) 492–497

Abstract: Unlabelled: Introduction Trauma patients in the extremes of age may require a specialized approach during a multiple-casualty incident (MCI). Problem The aim of this study was to examine the type of injuries encountered in children and elderly patients ... ...

Abstract	Unlabelled: Introduction Trauma patients in the extremes of age may require a specialized approach during a multiple-casualty incident (MCI). Problem The aim of this study was to examine the type of injuries encountered in children and elderly patients and the implications of these injuries for treatment and organization. Methods: A review of medical record files of patients admitted in MCIs in one Level II trauma center was conducted. Patients were classified according to age: children (≤12 years), adults (between 12-65 years), and elders (≥65 years). Results: The files of 534 were screened: 31 (5.8%) children and 54 (10.1%) elderly patients. One-third of the elderly patients were either moderately or severely injured, compared to only 6.5% of the children and 11.1% of the adults (P<.001). Elderly patients required more blood transfusions (P=.0001), more computed tomography imaging (P=.0001), and underwent more surgery (P=.0004). Elders were hospitalized longer (P=.0003). There was no mortality among injured children, compared to nine (2.0%) of the adults and seven (13.0%) of the elderly patients (P<.0001). All the adult deaths occurred early and directly related to their injuries, whereas most of the deaths among the elderly patients (four out of seven) occurred late and were due to complications and multiple organ failure. Conclusions: Injury at an older age confers an increased risk of complications and death in victims of MCIs. Ashkenazi I , Einav S , Olsha O , Turegano-Fuentes F , Krausz MM , Alfici R . The impact of age upon contingency planning for multiple-casualty incidents based on a single center's experience. Prehosp Disaster Med. 2016;31(5):492-497.
MeSH term(s)	Adolescent ; Adult ; Age Factors ; Aged ; Child ; Explosions ; Female ; Humans ; Male ; Mass Casualty Incidents ; Medical Audit ; Middle Aged ; Retrospective Studies ; Terrorism ; Trauma Centers ; Triage/organization & administration ; Young Adult
Language	English
Publishing date	2016-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	1025975-2
ISSN	1945-1938 ; 1049-023X
ISSN (online)	1945-1938
ISSN	1049-023X
DOI	10.1017/S1049023X16000613
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