What's new in trauma and burns

THE PAST YEAR has been characterized by vigorous basic anti clinical research that has clarified and expanded concepts of trauma care. Several key publications have opened the door to new improvements in clinical practice and have focused on successful processes of trauma management that should lead to improved outcomes, cost-effective patient care, and new data that will make productive future research possible. Because the field of trauma is broad and dynamic, some limitations of the scope of overviews such as this are inevitable. Therefore, I have chosen to restrict my comments to the following areas: trauma centers and trauma systems; research in trauma; burns; shock and resuscitation; neurological injury; fractures; nutrition; cardiovascular topics pertinent to trauma; and diagnosis, priority setting, and management of abdominal injuries. The basis of this article has been a comprehensive review of the clinical and basic science literature for the interval of November 1, 1994 to November 1, 1995. A few references appearing outside of this time frame have been included to provide broadened perspective for a particular subject. Special attention has been given to the proceedings of the Clinical Congress of the American College of Surgeons held in New Orleans on October 22 to 27, 1995 and the annual meeting of the American Association for the Surgery of Trauma which, this year, was a joint meeting with the Trauma Association of Canada and was held in Halifax, Nova Scotia on September 27 to 30, 1995.