OBJECTIVE: To review the application and research progress of artificial intelligence (AI) technology in trauma treatment. METHODS: The recent research literature on the application of AI and related technologies in trauma treatment was reviewed and summarized in terms of prehospital assistance, in-hospital emergency care, and post-traumatic stress disorder risk regression prediction, meanwhile, the development trend of AI technology in trauma treatment were outlooked. RESULTS: The AI technology can rapidly analyze and manage large amount of clinical data to help doctors identify patients' situation of trauma and predict the risk of possible complications more accurately. The application of AI technology in surgical assistance and robotic operations can achieve precise surgical plan and treatment, reduce surgical risks, and shorten the operation time, so as to improve the efficiency and long-term effectiveness of the trauma treatment. CONCLUSION There is a promising future for the application of AI technology in the trauma treatment. However, it is still in the stage of exploration and development, and there are many difficulties of historical data bias, application condition limitations, as well as ethical and moral issues need to be solved.
Humans ; Artificial Intelligence ; Operative Time ; Robotic Surgical Procedures ; Technology

Humans ; Consensus ; East Asian People ; Perioperative Care/standards* ; Risk Assessment ; Surgical Procedures, Operative ; Cardiovascular Diseases/therapy*

Introduction: Skills training using artificial bones became more critical in response to the Orthopedic surgical training restriction caused by the COVID-19 pandemic. To cut the expenses of buying commercial artificial bones, the Ilizarov Limb Reconstruction Service has decided to fabricate its artificial bones for surgical skills training. Objective: To determine if resin-coated polyurethane (PU) rigid foam is a suitable, low-cost alternative to commercial artificial bone. Methods: Tibiae were fabricated using PU rigid foam coated with epoxy resins. Three randomly selected fabricated tibia, and one standard artificial tibia was subjected to drilling with drill bits and K-wires. The time to penetration of one cortex of the three segments of the tibiae was recorded in seconds. An actual circular external fixator was applied. The actual cost of production was calculated. Results: Each fabricated tibia costs ₱456.93. The fabricated tibiae mean time to penetration was 2.15s and 3.37s using drill bits and K-wires. The commercial artificial bone mean time to penetration was 3.41s and 3.57s with drill bits and K-wires. The fabricated tibia was able to withstand the application of a circular external fixator and corticotomy. Conclusion The fabricated tibia is a suitable and more affordable simulation model for surgical skills training.
Education ; Surgical Procedures, Operative

Objective: To observe the treatment effect of hemifacial dysplasia by injecting transplantation of autologous dermis and fat granules in the second stage surgery for total auricle reconstruction. Methods: From March 2013 to March 2018, 57 patients with unilateral microtia and mild-to-moderate hemifacial dysplasia were divided into concurrent treatment group (32 cases, including 13 females and 19 males and aged 6-33 years old with an average age of 12.5 years) and traditional treatment group (25 cases, including 10 females and 15 males and aged 6-21 years old with an average age of 11.3 years) according to the different surgical methods. Modified Nagata method of auricular reconstruction was chosen, in the second stage surgery (cranial ear angle plasty), patients in concurrent treatment group received the treatment of hemifacial dysplasia with autologous dermal and fat injection transplantation at the same time; Patients in traditional treatment group only received cranial ear angle plasty. Statistical analysis of the two groups of patients was carried out for the average operation time, the average length of hospital stay, the incidence of common complications and postoperative satisfaction rate. SPSS 21.0 software was used for statistical analysis. Results: The mean operation time of the concurrent treatment group (282.0±3.4)min was longer than that of the traditional treatment group (243.0±3.1)min, and the difference was statistically significant (t=9.884, P<0.05). There were no statistically significant differences in the average length of stay between the the concurrent treatment group (9.4±0.3)d and the traditional treatment group(9.5±0.2)d, t=0.256, P>0.05. There were no statistically significant differences in the incidence of common surgical complications between the concurrent treatment group (12.5%, 4/32) and the traditional treatment group(12.0%, 3/25), χ²=0, P>0.05. Postoperative satisfaction rate of the concurrent treatment group(90.6%, 29/32) was significantly higher than that of the traditional treatment group(56.0%, 14/25), the difference was statistically significant (χ²=9.081, P<0.05). Conclusions: Auricular reconstruction with treatment of hemifacial dysplasia should not significantly increase the average length of stay and the incidence of common complications compared with auricular reconstruction alone. Although the operation time is slightly extended, the scheme of concurrent treatment can reduce the times of operations, save medical resources and increase the satisfaction rate of patients.
Adolescent ; Adult ; Child ; Congenital Microtia/surgery* ; Ear Auricle/surgery* ; Ear, External/surgery* ; Female ; Humans ; Male ; Operative Time ; Reconstructive Surgical Procedures ; Treatment Outcome ; Young Adult

COVID-19/prevention & control* ; Communicable Disease Control ; General Surgery/organization & administration* ; Guidelines as Topic ; Health Care Rationing ; Health Services Needs and Demand ; Health Workforce ; Humans ; Practice Guidelines as Topic ; SARS-CoV-2 ; Singapore/epidemiology* ; Surgical Procedures, Operative ; Triage

Objective To explore the predictive ability of the revised cardiac risk index(RCRI)in elderly patients with coronary heart disease(CHD)undergoing non-cardiac surgery. Methods We performed a retrospective study including a total of 2100 patients,aged≥65 with a history of CHD who underwent non-cardiac surgery form January 2013 to September 2019.The preoperative,intraoperative and postoperative clinical data were extracted from an electronic database.The RCRI and reconstructed-RCRI(R-RCRI)score of each patient were calculated.The primary end point was defined as an occurrence of perioperative MACE.Multivariate logistic regression analysis was performed to evaluate the risk factors of perioperative MACE.The area under the receiver operating characteristic(ROC)curve was used to compare the predictive value of RCRI,R-RCRI,and the new risk scoring system of the study for perioperative MACE. Results The incidence of perioperative MACE in elderly patients with CHD was 5.4%.Six independent risk factors of perioperative MACE for this population were identified:age≥80 years;female;history of heart failure;insulin-depended diabetes mellitus;preoperative ST segment abnormality;American Society of Anesthesiologists grade≥Ⅲ,and the risk index was 2,2,2,2,2 and 3 respectively.The area under ROC curve of RCRI,R-RCRI and risk scoring system in this study were 0.586,0.552 and 0.741. Conclusion The correlation between RCRI score and perioperative MACE was poor in elderly patients with CHD undergoing non-cardiac surgery,and a better cardiac risk assessment method should be established for this population.
Aged ; Coronary Disease/complications* ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Postoperative Complications/epidemiology* ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Surgical Procedures, Operative

Enhance recovery after surgery (ERAS) is an emerging discipline aiming to reduce perioperative stress response and postoperative complications and promote better and faster recovery of patients. In this study, the potential value and feasibility of acupuncture in ERAS is discussed from three aspects: acupuncture can reduce the demand of perioperative analgesic drugs, improve the postoperative gastrointestinal function, and prevent and treat postoperative complications. The combination of acupuncture and ERAS can better promote the rehabilitation of patients, complement the advantages of acupuncture and ERAS, and promote the development of acupuncture and ERAS.
Acupuncture Therapy ; Analgesics ; Enhanced Recovery After Surgery ; Humans ; Moxibustion ; Postoperative Complications ; Surgical Procedures, Operative

Betacoronavirus ; Coronavirus Infections ; epidemiology ; transmission ; Disease Transmission, Infectious ; prevention & control ; Humans ; Incidence ; Pandemics ; Pneumonia, Viral ; epidemiology ; transmission ; Singapore ; epidemiology ; Surgical Procedures, Operative ; standards

PURPOSE: The purpose of this study was to compare the clinical and radiological outcomes of locking compression plate (LCP)-screw fixation and tension band wiring (TBW) fixation in isolated lateral malleolar fractures.MATERIALS AND METHODS: From May 2016 to August 2018, 52 patients with isolated lateral malleolar fracture were retrospectively reviewed. They were divided into 30 cases of the LCP fixation group (Group I) and 22 cases of the TBW fixation group (Group II). The clinical and radiological results of those groups were compared. Pearson chi-square tests and independent t-tests were used in the statistical analysis.RESULTS: The mean length of the surgical incision was 8.3 cm in Group I and 4.9 cm in Group II. Radiological union was obtained at a mean of 8.4 weeks in both groups. The mean American Orthopaedic Foot and Ankle Society score was 90 (range, 85–97) and 92 (range, 85–100) in Groups I and II, respectively, at the last follow up.CONCLUSION: Both the LCP-screw and TBW techniques revealed excellent results in isolated lateral malleolar fractures. The tension band technique may be a fine alternative method of fixation in the treatment of isolated lateral malleolar fracture.
Ankle ; Ankle Fractures ; Follow-Up Studies ; Foot ; Humans ; Methods ; Retrospective Studies ; Surgical Procedures, Operative

OBJECTIVES: Bispectral index (BIS) can reflect the depth of propofol sedation. This study aims to compare the anesthetic satisfaction, anesthetic dose, and hemodynamic changes between closed-loop target controlled infusion (CLTCI) and open-loop target controlled infusion (OLTCI) during abdominal surgery. METHODS: From December 2016 to December 2018, 70 patients undergoing abdominal surgery under general anesthesia were selected in Beijing Hospital, including 51 males and 19 females, at the age from 49 to 65 years old. They were classified as grade I-II by the American Society of anesthesiologists (ASA) and were randomly divided into the CLTCI group and the OLTCI group ( RESULTS: In the induction stage, the percentage of adequate anesthesia time in the CLTCI group was higher than that in the OLTCI group, and the percentage of deep anesthesia time in the CLTCI group was significantly lower than that in the OLTCI group (both CONCLUSIONS Compared with propofol OLTCI, anesthesia with propofol CLTCI under BIS guidance can maintain a more appropriate depth of anesthesia sedation and more stable hemodynamics.
Abdomen/surgery* ; Aged ; Anesthesia, General ; Anesthesia, Intravenous ; Anesthetics, Intravenous ; Electroencephalography ; Female ; Humans ; Male ; Middle Aged ; Propofol ; Remifentanil ; Surgical Procedures, Operative