Donald D. Trunkey

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The records of all 437 persons who died from trauma in San Francisco in 1977 were examined. Sixty-five percent of the sample (285 younger than 50 years, and 119 were between ages 21 and 30. Gunshot wounds (140 or 32 percent) and falls (122 or 28 percent) were the most common causes of injury. Fifty-three percent of the sample were dead at the scene of(More)
OBJECTIVE To determine the current opinion of American trauma surgeons on the use of the open abdomen to prevent the abdominal compartment syndrome (ACS). METHODS On a questionnaire survey of expert trauma surgeons regarding 12 clinical factors influencing fascial closure at trauma celiotomy, surgeons graded their willingness to close the fascia in(More)
OBJECTIVE To determine whether prevention of the abdominal compartment syndrome after celiotomy for trauma justifies the use of absorbable mesh prosthesis closure in severely injured patients. DESIGN Retrospective analysis of case series from July 1, 1989, to July 31, 1996. SETTING University-based level I trauma center. PATIENTS Seventy-three(More)
Until recently the development of systems for trauma care in the United States has been inextricably linked to wars. During the Revolutionary War trauma care was based on European trauma principles particularly those espoused by the Hunter brothers. Surgical procedures were limited mostly to soft tissue injuries and amputations. The American Civil War was(More)
In a continuation of a trial for which preliminary results were reported in the Journal two years ago, a total of 64 patients with Child Class C cirrhosis and variceal hemorrhage requiring six or more units of blood were randomly assigned to receive either a portacaval shunt (32 patients) or endoscopic sclerotherapy (32 patients). The duration of initial(More)
Computed tomographic (CT) scans are used to evaluate victims of blunt trauma for abdominal injury when reasons for immediate laparotomy are not present. Twenty-four patients whose CT scans showed liver injuries that were small parenchymal lacerations or intrahepatic hematomas were managed without laparotomy. Intra-abdominal blood was absent or estimated to(More)
Cases of motor vehicle trauma victims who died after arrival at a hospital were evaluated in both Orange County (90 cases) and in San Francisco County (92 cases), Calif. All victims in San Francisco County were brought to a single trauma center, while in Orange County they were transported to the closest receiving hospital. Approximately two thirds of the(More)
We reviewed 144 consecutive patients with flail chest and/or pulmonary contusion between 1979 and 1984. The purpose was to analyze the factors adversely affecting morbidity and mortality. There were 97 males and 47 females, with an average age of 40 years +/- 18 S.D. (range, 2-83). Seventy-five per cent of the injuries were caused by motor vehicle(More)
Dr. Mock and his associates have addressed a significant and complex global health problem, i.e., 5 million deaths each year from trauma [1]. Tragically, they estimate that between 1,730,000 and 1,965,000 lives could be saved in lowand middle-income countries. This estimate has some limitations, which the authors have acknowledged. In fairness, they have(More)