Journal of Trauma and Injury

Original Article

Inhaled amikacin as a preventive strategy against ventilator-associated pneumonia in a trauma intensive care unit: early evidence from a single-center retrospective cohort study: Ohchul Kwon, Nahyeon Lee, Seok Hwa Youn, Younghwan Kim, Mina Kim, Jinho Jheong, Gaesung Ha, Youngwoong Kim; J Trauma Inj. 2025;38(4):343-352. Published online December 31, 2025; DOI: https://doi.org/10.20408/jti.2025.0145

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Abstract PDF Supplementary Material: Purpose
Ventilator-associated pneumonia (VAP) remains a leading cause of morbidity and mortality in intensive care units (ICUs). The effectiveness of prophylactic inhaled amikacin in preventing VAP remains uncertain. This study compared VAP incidence between patients with trauma who received prophylactic inhaled amikacin and those who did not.
Methods
We conducted a retrospective, single-center analysis of 66 mechanically ventilated trauma patients admitted to the ICU between May and December 2024. Primary outcomes were infection-related ventilator-associated conditions (IVAC) and microbiologically confirmed VAP. Secondary outcomes included mechanical ventilation duration, ICU and hospital length of stay, and 30-day mortality. Statistical analyses comprised chi-square tests, multivariate logistic regression, and Cox proportional hazards regression with propensity score matching.
Results
A total of 66 patients were included: 28 in the prophylaxis group and 38 in the control group. The prophylaxis group demonstrated a higher unadjusted incidence of IVAC (85.71% vs. 55.26%, P=0.02) and VAP (82.14% vs. 44.74%, P<0.01) compared with the control group. However, after adjustment, logistic regression revealed no significant association between inhaled amikacin and increased risk of VAP (odds ratio [OR], 3.00; 95% confidence interval [CI], 0.80–12.81; P=0.11) or IVAC (OR, 3.10; 95% CI, 0.71–16.43; P=0.15). Similarly, Cox regression analysis showed no significant effect on VAP (hazard ratio [HR], 1.10; 95% CI, 0.47–2.58; P=0.82) or IVAC (HR, 1.68; 95% CI, 0.78–3.59; P=0.18). Secondary outcomes did not differ significantly between groups.
Conclusions
Prophylactic inhaled amikacin neither prevented nor increased IVAC and VAP risk in mechanically ventilated trauma patients, suggesting no meaningful impact on VAP outcomes in this population.; Summary

Case Report

Purtscher retinopathy following isolated chest compression: a case report: Min Uk Jang, Ho Gil Jung, Youngwoong Kim; J Trauma Inj. 2024;37(4):291-294. Published online October 21, 2024; DOI: https://doi.org/10.20408/jti.2024.0032

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Abstract PDF: This case report describes the case of a 56-year-old man who developed Purtscher retinopathy following compressive chest trauma. During the tertiary survey, the patient was found to have a unilateral partial vision decline despite sustaining only mild rib fractures. The patient was diagnosed with a rare complication of Purtscher retinopathy. At a 2-week follow-up outpatient examination, improved visual acuity was observed. This case highlights the importance of conducting a tertiary survey not only on the directly impacted site, but also comprehensively across all sites, while attentively listening to and addressing the patient’s complaints.; Summary

Original Article

Clinical characteristics of patients with the hardware failure after surgical stabilization of rib fractures in Korea: a case series: Na Hyeon Lee, Sun Hyun Kim, Seon Hee Kim, Dong Yeon Ryu, Sang Bong Lee, Chan Ik Park, Hohyun Kim, Gil Hwan Kim, Youngwoong Kim, Hyun Min Cho; J Trauma Inj. 2023;36(3):196-205. Published online September 5, 2023; DOI: https://doi.org/10.20408/jti.2023.0026

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3 Citations

Abstract PDF

Purpose
Surgical stabilization of rib fractures (SSRF) is widely used in patients with flail chests, and several studies have reported the efficacy of SSRF even in multiple rib fractures. However, few reports have discussed the hardware failure (HF) of implanted plates. We aimed to evaluate the clinical characteristics of patients with HF after SSRF and further investigate the related factors.
Methods
We retrospectively reviewed the electronic medical records of patients who underwent SSRF for multiple rib fractures at a level I trauma center in Korea between January 2014 and January 2021. We defined HF as the unintentional loosening of screws, dislocation, or breakage of the implanted plates. The baseline characteristics, surgical outcomes, and types of HF were assessed.
Results
During the study period, 728 patients underwent SSRF, of whom 80 (10.9%) were diagnosed with HF. The mean age of HF patients was 56.5±13.6 years, and 66 (82.5%) were men. There were 59 cases (73.8%) of screw loosening, 21 (26.3%) of plate breakage, 17 (21.3%) of screw migration, and seven (8.8%) of plate dislocation. Nine patients (11.3%) experienced wound infection, and 35 patients (43.8%) experienced chronic pain. A total of 21 patients (26.3%) underwent reoperation for plate removal. The patients in the reoperation group were significantly younger, had fewer fractures and plates, underwent costal fixation, and had a longer follow-up. There were no significant differences in subjective chest symptoms or lung capacity.
Conclusions
HF after SSRF occurred in 10.9% of the cases, and screw loosening was the most common. Further longitudinal studies are needed to identify risk factors for SSRF failure.

Summary

Citations

Citations to this article as recorded by

Sternal Hardware Migration Following Rigid Plate Fixation After Coronary Artery Bypass Graft
Hao Huang, Craig R. Smith, Jeffrey A. Ascherman
Annals of Thoracic Surgery Short Reports.2026; 4(1): 291. CrossRef
Komplikationen nach Thoraxtrauma
Stefan Schulz-Drost, Christof Schreyer, Christopher Spering, Paula Beck, Stephan Raab, Lars Becker, Sebastian Brill
OP-Journal.2025; 41(02): 134. CrossRef
Komplikationen nach operativer vs. konservativer Versorgung des schweren Thoraxtraumas
Lars Becker, Marcel Dudda, Christof Schreyer
Die Unfallchirurgie.2024; 127(3): 204. CrossRef

Case Report

Case reports of iatrogenic vascular injury in the trauma field: what is the same and what is different?: Youngwoong Kim, Kyunghak Choi, Seongho Choi, Min Ae Keum, Sungjeep Kim, Kyu-Hyouck Kyoung, Jihoon T Kim, Minsu Noh; J Trauma Inj. 2022;35(2):123-127. Published online December 24, 2021; DOI: https://doi.org/10.20408/jti.2021.0088

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Abstract PDF: Iatrogenic vascular injury (IVI) can occur with any technique or type of surgery performed around a blood vessel. Patients with severe trauma are at risk of IVI. In this study, we describe our experiences of IVI in the trauma field. We reviewed five patients who were diagnosed with an IVI and received either surgical or endovascular treatment. Of the five patients, one had an arterial injury, three had venous injuries, and one had an arteriovenous fistula, a form of combined arterial and venous injuries. Of the five patients, four had undergone orthopedic surgery. The IVIs of three patients were immediately identified in the operating room and simultaneous vascular repair was performed. The remaining one patient underwent additional surgery for occlusion related to entrapment of the superficial femoral artery by a surgical wire used during orthopedic surgery. Complications presumably related to the IVI were identified in two patients. IVI in trauma patients can be successfully managed, but significant morbidity can occur. If an IVI is suspected, immediate evaluation and management are required.; Summary

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