| Diagnostic protocol and imaging techniques |
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Use of ATLS guidelines and incorporating a tertiary survey preferably by an orthopedician to reduce the risk of missed injuries
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Use of whole body CT and other imaging protocols safely while reducing radiation hazard to the patient
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| Endpoints of Resuscitation, and predictive models of complications |
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Combination of hemodynamic stability, acid-base markers (serum lactate and base deficit) along with other physiological markers (PT, INR, platelet count, fibrinogen) for assessing the adequacy of resuscitation
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Validation of recent technological advancements like dynamic platelet function tests on outcomes in polytrauma patients
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Validation of predictive models of outcomes in polytrauma patients in different populations for large scale applications
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Advent of Artificial Intelligence and patient-specific genomics for developing new markers for assessing adequacy of resuscitation
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Developing patient-specific management protocols based on individual differences in response to injury by the use of patient-specific genomics and artificial intelligence
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| Traumatic Brain Injury (TBI) and Extremity injury management |
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Extended hospitalization with delayed fracture care increases ICU stay and more pulmonary and neurologic problems in patients with delayed fracture fixation along with increased fracture related complications like non union and malunion
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In hemodynamically stable patients early definitive fixation can be performed whereas in unstable patients management should follow principles of DCO
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Newly developed strategies of treatment like “Early Appropriate Care” needs to be validated across large and heterogeneous population groups before their large-scale application across different geographical areas
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Development of Clinical Decision Support Tools that can help in choice and timing of surgical interventions in polytrauma patients with varying patterns of injury
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Development of validated scoring systems and prognostic indicators with the help of precision medicine
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Validating theoretical beliefs of a complex interplay of pro and anti-inflammatory cytokines during the treatment of polytrauma patients for developing treatment algorithms
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Identification of specific immunological markers associated with the development of complications and poor or good outcomes
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| Chest Injury and Extremity injury management |
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Quantification of the severity of chest trauma by scoring systems like Thoracic Trauma Score can help in the prediction of complications and allow better management
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Staged surgical approach for fracture stabilization instead of simultaneous multiple fracture fixations within 24 h of injury in unstable patients and definitive fracture fixation in stable patients based on individual patient physiology
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| Abdominal Injury and Extremity injury management |
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Early fracture fixation improves pulmonary function and reduces overall mortality risk in carefully selected stable patients with an abdominal injury
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Low risk of clinically relevant surgical site infections after fracture fixation in presence of open abdomen
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| Open Extremity Injuries |
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Early debridement within 24 h is recommended and early closure of most grade I, II, IIIa can be performed
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Early Initiation of systemic antibiotic coverage directed at Gram-positive organisms based on current evidence-based strategies to minimize the risk of infection in fractures
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Skeletal stabilization should be undertaken quickly, especially in the setting of the vascular deficit, and it must be designed to allow future soft tissue reconstruction
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Use of unilateral half pin external fixators as a means of definitive management is no longer recommended
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Primary internal fixation can be considered if soft tissue cover could be achieved within 48–72 h
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