J A Asensio

Hospital Universitario Nuestra Señora de Candelaria, Cancelaria, Canary Islands, Spain

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Publications (189)411.39 Total impact

  • Current Problems in Surgery 10/2014; · 2.08 Impact Factor
  • European Journal of Trauma and Emergency Surgery 01/2014; · 0.26 Impact Factor
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    ABSTRACT: Background Multimodality monitoring and goal directed therapy (MM&GDTP) may not prevent blood flow and brain oxygen (Flow/BrOx) crisis. We sought to determine the impact of these events on outcome in patients with severe TBI (sTBI). Methods 24 patients with sTBI were treated to maintain ICP≤ 20 mmHg, CPP ≥ 60 mmHg, brain oxygen (PbtO2) ≥ 20 mm Hg, and Near Infrared Spectroscopy (NIRS) ≥ 60%. Flow/BrOx crisis events were recorded. The 14-day predicted mortality (PM) was compared to actual mortality (AM). Results Non-survivors (NS) had a significantly higher number of crisis events non-responsive to treatment, p < 0.05. Mortality was 87.5% versus 6.3% in patients with ≥ 20 and < 20 events, respectively. The PM was 58% whereas AM was 33.3% (8/24), yielding a 42% reduction in mortality. Conclusions A MM&GDTP may decrease mortality in sTBI. However, Flow/BrOx crisis events still occur and predict a poor outcome.
    The American Journal of Surgery. 01/2014;
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    ABSTRACT: Explosives create and energize particles that act as projectiles prone to further fragmentation or create other secondary missiles in the body. These fragments may result in secondary injuries. This has been repeatedly described in the orthopedic and neurosurgical literature. We report the same process for abdominal injuries after fascial penetration in the military setting. This is an observational case series study. Local wound exploration as a standard approach was performed in conscious patients who sustained abdominal wall injuries. Patients with negative physical examination were excluded from the study. An intraperitoneal injury was assumed in those with a full-thickness fascial defect, and laparotomy was performed. Twenty patients met the study eligibility criteria. Of those 20 patients, 12 had negative wound exploration and were excluded from the study, while abdominal organ injuries were found in eight (40%) patients. During laparotomy, projectile-induced injuries in a sprayed distribution were found in three (38%) of these patients. These injuries were far from the predictable trajectory and in the absence of bone fragmentation. The overall mean number of peritoneal defects was 1.7, and a mean 6.8 intra-abdominal injuries for each peritoneal defect were found when through-and-through injuries were excluded.Despite a single peritoneal defect, there may be multiple intraperitoneal injuries due to further fragmentation of the projectile. Under mass casualties, wound exploration with a full-thickness fascial defect could serve as an indicator of possible intra-abdominal injuries, and consequently indicate exploratory laparotomy.
    Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery: TJTES 11/2012; 18(6):531-4. · 0.34 Impact Factor
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    T Vu, F N Mazzini, J A Asensio
    Annals of The Royal College of Surgeons of England 10/2012; 94(7):530. · 1.33 Impact Factor
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    ABSTRACT: Abdominal vascular lesions are amongst the most lethal lesions suffered by patients with multiple injuries, as well as being among the most difficult and challenging for the surgeon. They are rarely isolated, they are usually found with associated multiple injuries, which increases its seriousness and the time required to repair them and may lead to a significant morbidity and mortality. The correct management involves an early diagnosis and surgical approach.
    Cirugia Espanola - CIR ESPAN. 04/2012;
  • Juan Manuel Sánchez, Pablo Menéndez, Juan Antonio Asensio
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    ABSTRACT: Abdominal vascular lesions are amongst the most lethal lesions suffered by patients with multiple injuries, as well as being among the most difficult and challenging for the surgeon. They are rarely isolated, they are usually found with associated multiple injuries, which increases its seriousness and the time required to repair them and may lead to a significant morbidity and mortality. The correct management involves an early diagnosis and surgical approach.
    Cirugía Española 02/2012; 90(4):215-21. · 0.87 Impact Factor
  • T Vu, K D Stahl, J A Asensio
    Annals of The Royal College of Surgeons of England 09/2011; 93(6):490-1. · 1.33 Impact Factor
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    ABSTRACT: Upper extremity injuries are increasingly common among peripheral vascular injuries, as a result of penetrating trauma (Figure 18.1). Blunt trauma may also result in significant vascular injury primarily due to associated injuries such as fractures and dislocations. Injuries to the brachial artery are most commonly reported.
    01/2011: pages 403-411;
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    ABSTRACT: Every surgeon carries about him a little cemetery, in which from time to time he goes to pray, a cemetery of bitterness and regret, of which he seeks the reason for certain of his failures. (Rene Leriche [1879–1955])
    01/2011: pages 369-380;
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    ABSTRACT: Vascular injuries to the extremities are relatively uncommon. They are generally seen in most major trauma centers (Figure 17.1). The majority of these injuries are the result of penetrating trauma such as gunshots (GSW), stab wounds (SW), and shotgun wounds (SGW). Similar mechanisms prevail in military arenas of warfare. In addition, in combat conditions, vascular injuries are also caused by antipersonnel devices including landmines and improvised explosive devices as well as by shrapnel or missile fragments. In contrast to civilian extremity vascular injuries, military injuries are usually accompanied by extensive soft tissue destruction.
    01/2011: pages 393-401;
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    ABSTRACT: Introduction Thoracic and thoracic related vascular injuries represent complex challenges to the trauma surgeon. Subclavian vessel injuries, in particular, are uncommon and highly lethal. Regardless of the mechanism, such injuries can result in significant morbidity and mortality. Materials and methods Systematic review of the literature, with emphasis on the diagnosis, treatment and outcomes of these injuries, incorporating the authors’ experience. Conclusions These injuries are associated with significant morbidity and mortality. Patients who survive transport are subject to potentially debilitating injury and possibly death. Management of these injuries varies, depending on hemodynamic stability, mechanism of injury, and associated injuries. Despite significant advancements, mortality due to subclavian vessel injury remains high.
    European Journal of Trauma and Emergency Surgery 01/2011; · 0.26 Impact Factor
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    ABSTRACT: Introduction Axillary vessel injuries are uncommon and challenging injuries encountered by trauma surgeons. Proximity of this vessel to other adjacent veins including the axillary vein, brachial plexus and the osseous structures of the shoulder and upper arm account for a large number of associated injuries. Materials and methods Systematic review of the literature, with emphasis on the diagnosis, treatment and outcomes of these injuries, incorporating the authors’ experience. Conclusions Although uncommon, axillary arterial injuries can result in significant morbidity, limb loss and mortality. Early diagnosis and timely repair of the artery leads to good outcomes.
    European Journal of Trauma and Emergency Surgery 01/2011; · 0.26 Impact Factor
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    ABSTRACT: Carotid arterial injuries are the most difficult and certainly the most immediately life-threatening injuries found in penetrating neck trauma. Their propensity to bleed actively and potentially occludes the airway and makes surgical intervention very challenging. Their potential for causing fatal neurological outcomes demands that trauma surgeons exercise excellent judgment in the approach to their definitive management. The purpose of this article is to review the diagnosis and management of these injuries.
    European Journal of Trauma and Emergency Surgery 01/2011; · 0.26 Impact Factor
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    ABSTRACT: Introduction Reports of arterial injuries from both the civilian and military arenas report the brachial artery as the most frequently injured vessel, accounting for approximately 25–33% of all peripheral arterial injuries. The brachial artery is surrounded by important peripheral nerves —the median, ulnar and radial, and also parallels the humerus and associated veins. Due to its close proximity to these structures, associated nerve and osseous injuries are frequent with residual neuropathy from such nerve injuries, often the main sources of permanent disability. Materials and methods Systematic review of the literature, with emphasis in the diagnosis, treatment and outcomes of these injuries, incorporating the authors experience. Conclusions The morbidity and mortality rates associated with brachial artery injuries depend on the cause of the injury itself, which vein or tendon is injured, and whether musculoskeletal and nerve injuries are also present. During the last 20 years, amputation associated with upper extremity arterial injuries has decreased to a rate of 3% because of advances in the treatment of shock, the use of antibiotic therapy, and increased surgical experience.
    European Journal of Trauma and Emergency Surgery 01/2011; · 0.26 Impact Factor
  • Juan Manuel Verde, Asensio JA
    01/2011: pages 1699-1703;
  • P. Menéndez, J. M. Sánchez, J. A. Asensio
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    ABSTRACT: Penetrating neck trauma accounts for approximately 5–10 % of all penetrating trauma patients. Approximately 30 % of those admitted with penetrating neck injuries incur vascular injuries. Their overall mortality of 20–40 % and morbidity rates are significantly higher than for those patients that sustain penetrating trauma. Management with good outcomes depends on early diagnosis and prompt surgical treatment. We describe the methodology for the approach and surgical management of the vascular injuries of the neck.
    American Journal of Human Genetics - AMER J HUM GENET. 01/2010; 62(4):150-156.
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    The Journal of trauma 08/2009; 67(1):E14-6. · 2.35 Impact Factor
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    Journal of the American College of Surgeons 04/2009; 208(3):462-72. · 4.50 Impact Factor
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    Patrizio Petrone, Juan A Asensio
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    ABSTRACT: Chest injuries were reported as early as 3000 BC in the Edwin Smith Surgical Papyrus. Ancient Greek chronicles reveal that they had anatomic knowledge of the thoracic structures. Even in the ancient world, most of the therapeutic modalities for chest wounds and traumatic pulmonary injuries were developed during wartime. The majority of lung injuries can be managed non-operatively, but pulmonary injuries that require operative surgical intervention can be quite challenging. Recent progress in treating severe pulmonary injuries has relied on finding shorter and simpler lung-sparing techniques. The applicability of stapled pulmonary tractotomy was confirmed as a safe and valuable procedure. Advancement in technology have revolutionized thoracic surgery and ushered in the era of video-assisted thoracoscopic surgery (VATS), providing an alternative method for accurate and direct evaluation of the lung parenchyma, mediastinum, and diaphragmatic injuries. The aim of this article is to describe the incidence of the penetrating pulmonary injuries, the ultimate techniques used in its operative management, as well as the diagnosis, complications, and morbidity and mortality.
    Scandinavian Journal of Trauma Resuscitation and Emergency Medicine 03/2009; 17:8. · 1.68 Impact Factor

Publication Stats

4k Citations
411.39 Total Impact Points

Institutions

  • 2012
    • Hospital Universitario Nuestra Señora de Candelaria
      Cancelaria, Canary Islands, Spain
  • 2011–2012
    • University of Miami
      كورال غيبلز، فلوريدا, Florida, United States
  • 2009–2012
    • University of Miami Miller School of Medicine
      • • Department of Surgery
      • • Division of Trauma and Surgical Critical Care
      Miami, Florida, United States
  • 1997–2009
    • University of Southern California
      • Department of Surgery
      Los Angeles, CA, United States
  • 1996–2009
    • University of California, Los Angeles
      • Department of Surgery
      Los Angeles, CA, United States
  • 2007
    • Stavanger University Hospital
      • Division of Surgery
      Stavanger, Rogaland Fylke, Norway
  • 2000–2003
    • Keck School of Medicine USC
      Los Angeles, California, United States