Journal of Trauma and Injury

Original Articles

Vascularized tissue coverage of trauma and acute care surgery defects with ovine forestomach matrix: interim results of a prospective multicenter study: Michael T. Cormican, W. Matthew Vassy, Carolyn Cook, Christopher A. Butts, John Loftus, Jessica Simon, D. Adam Young, Alison A. Smith; J Trauma Inj. 2026;39(1):42-51. Published online January 20, 2026; DOI: https://doi.org/10.20408/jti.2025.0090

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Purpose
Traumatic soft tissue defects present challenges due to their diverse presentations. This variability necessitates tailored approaches for effective management, requiring advanced reconstruction strategies to achieve rapid coverage and tissue infill while minimizing complications. The study aimed to evaluate the safety of ovine forestomach matrix (OFM) grafts in traumatic defects from four level I trauma centers.
Methods
This prospective observational study used a multicenter registry to collect deidentified data from adult trauma/acute care surgery patients who received OFM-based grafts for soft tissue repair from August 2022 through September 2024. After the application of OFM grafts, defects were regularly assessed for the development of vascularized tissue coverage and/or fill, and ultimately epithelialization.
Results
During the study, 49 participants with 61 soft tissue defects underwent procedures with OFM-based grafts. The mean participant age was 58.8±17.7 years. Most defects (55.7%) resulted from traumatic injuries, with additional etiologies including necrotizing soft tissue infections (13.1%), enterocutaneous fistulas (4.9%), acute pressure injuries (stages III and IV, 6.6%), surgical dehiscence (4.9%), amputations (3.3%), and hematoma evacuation (3.3%). All defects achieved vascularized tissue coverage within a median of 22.5 days (interquartile range, 13.3–33.5 days) after a median of one product application (interquartile range, 1–1). Four cases of superficial infection were reported, all resolving without major complications.
Conclusions
OFM-based grafts showed promising results in tissue regeneration for trauma and acute care defects, with minimal postoperative complications. These results are interim findings from an ongoing prospective multicenter registry study evaluating the safety and efficacy of OFM-based grafts in various surgical applications.

Summary

Citations

Citations to this article as recorded by

Reconstruction of Deep Partial-Thickness Burns With Ovine Forestomach Matrix: Results From a Prospective Observational Study
Patrick J Kennedy, Michael Young, Kylie Wentworth, Nidhi Aravapalli, Nicole P Bernal, Ariel Rodgers, Laura Pezzopane, Beth McGuire, Jessica Simon, D. Adam Young, John Loftus
Cureus.2026;[Epub] CrossRef
Ovine forestomach matrix for wound treatment: an integrative review
Marcos Fortes, João Moreira, Ana Carolina Fernandes, Débora Wilbert
European Journal of Plastic Surgery.2026;[Epub] CrossRef
Surgical management of stage 3 and 4 pressure injuries in trauma patients using ovine forestomach matrix grafts: a prospective case series
Sophia M. Trinh, Kaitlyn Andre, Ada I. Özcan, Dhanushka S. Vitharana, Paige E. Deville, Joseph W. Mason, John P. Hunt, Alan B. Marr, Patrick P. Greiffenstein, Lance E. Stuke, Alison A. Smith
Frontiers in Surgery.2026;[Epub] CrossRef

From trauma surgery to acute care surgery: a 4-year observational study at a single trauma center in Korea: Jung-Woo Woo, Jae Yool Jang, Yo Seok Cho, Hongkyung Shin, Chan Yong Park; J Trauma Inj. 2025;38(4):382-388. Published online December 31, 2025; DOI: https://doi.org/10.20408/jti.2025.0248

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Abstract PDF: Purpose
The acute care surgery (ACS) model establishes the capacity to immediately accommodate nontraumatic emergency surgery requiring urgent treatment while simultaneously elevating the existing trauma care system to the highest level. This study aims to evaluate the 4-year experience of operating after expanding the trauma surgery domain to ACS at this institution, which was designated as a lower-level trauma center by the local government in 2020.
Methods
A retrospective study was conducted using clinical records for patients who underwent surgery in the Division of Trauma and Acute Care Surgery over a 54-month period, from March 2021 to August 2025.
Results
Trauma volumes remained stable (10–20 cases semiannually) after ACS implementation, with surgical case numbers similar to those recorded before its introduction. Nontrauma volumes increased from 3 cases in March–August 2023 to 163 in March–August 2025.
Conclusions
The transition from the trauma surgery model to the ACS model successfully increased the efficiency of trauma and emergency general surgery within the level II low-volume environment, accomplishing without reducing the existing trauma caseload. These findings support the adoption of ACS in similar emergency medical institutions and offer insights relevant for national policy development concerning emergency general surgery in Korea.; Summary

Correlation of base deficit and age shock index with in-hospital mortality in geriatric major trauma patients: a 1-year retrospective study at a single level I trauma center in Indonesia: Miftahul Khairat Musmar Elbama, M. Iqbal Rivai, Irwan , Avit Suchitra, Aulia Rahman, Rose Dinda Martini; J Trauma Inj. 2025;38(3):204-210. Published online September 3, 2025; DOI: https://doi.org/10.20408/jti.2025.0021

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Abstract PDF: Purpose
Base deficit (BD) and age shock index have been utilized as an indicator of resuscitation adequacy and a predictor of poor outcomes in trauma cases, respectively. However, evidence regarding their correlation with in-hospital mortality among geriatric major trauma patients remains scarce in the literature.
Methods
This analytical observational study employed a retrospective cohort design involving 82 geriatric major trauma patients treated at our institution between November 2023 and November 2024. Data were collected from patients’ medical records at admission (age, trauma mechanism, vital signs, Glasgow Coma Scale [GCS], Injury Severity Score, hemoglobin, BD, and comorbidities) and at discharge (survival or death).
Results
The geriatric major trauma patients who experienced in-hospital mortality were predominantly male, with an average age of 69.6 years. Traffic accidents constituted the most common trauma mechanism. Most patients presented with a GCS score between 13 and 15, and hypertension was the most frequently recorded comorbidity. BD demonstrated a significant correlation with in-hospital mortality (P<0.05). Severe BD was associated with the highest odds of in-hospital mortality (adjusted odds ratio, 40.72; 95% confidence interval, 2.90–560.86). Although age shock index did not directly correlate with mortality, it played a confounding role. Additionally, a GCS score of <9 was significantly correlated with in-hospital mortality (P<0.05).
Conclusions
The findings of this study can inform initial clinical management strategies for geriatric major trauma patients at trauma centers. Prompt resuscitation and treatment should be prioritized for patients presenting with moderate or severe BD to reduce preventable mortality in this population.; Summary

Case Report

Inferior vena cava injuries at a level I trauma center: a case series: Rachith Sridhar, Abdul Vakil Khan, Harendra Kumar, Abdul Hakeem, Deepak Kumar, Majid Anwer; J Trauma Inj. 2025;38(3):299-306. Published online June 27, 2025; DOI: https://doi.org/10.20408/jti.2025.0054

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Abstract PDF: Inferior vena cava (IVC) injuries are rare but deadly. Depending on the mechanism of injury, patient status, and type of injury, intervention may be surgical or endovascular. These injuries typically pose challenges in identification and treatment. During surgical intervention, rapid access and timely control of the bleeding site may be difficult. In this series, we aim to describe various IVC injuries presented at our center, detailing challenges and outcomes in their management. The study aims to characterize the presentation, interventions, and outcomes of IVC injury cases at a level I trauma center over a period of 30 months. In this report, a total of six cases of IVC injury were treated at our center. All patients underwent surgical intervention. Each patient experienced a high-energy trauma mechanism, with three patients sustaining blunt trauma and three sustaining penetrating trauma. Of the six patients, three survived while three died. Mortality was attributed to delayed presentation, complexity of injuries, and technical difficulties. Adherence to Advanced Trauma Life Support (ATLS) protocols, timely diagnosis and resuscitation, and rapid decision-making can reduce mortality associated with IVC injuries. Nonetheless, surgeons must remain cognizant of the inherent challenges and pitfalls in managing these injuries.; Summary

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