Trauma Program


Rajani Adiga, MS
Rajani Adiga, MS Research Coordinator

As the only Level I Trauma Center in central Georgia, The Medical Center, Navicent Health is well-known for the life-saving care it provides to its patients. Ongoing research aimed at improving patient outcomes is a strong component of the program. Trauma Services now has its first trauma research coordinator, Rajani Adiga, MS. She has an extensive background in research and data management and is responsible for administration and operation of the research projects. Current projects include both institutional and multi-institutional studies.

  • Rib Plating: Prospective randomized trial comparing resorbable plates and metal plates for the surgical stabilization of rib fractures
  • TEG Pattern Changes: Study to analyze whether Thromboelastography (TEG) parameter changes occur before, or at, the time of venous thromboembolism (VTE) diagnosis in the already at risk trauma patient population, therefore, allowing TEG pattern changes to provide predictive value for VTE risk escalation
  • Tourniquet Placement: Multi-institutional study to assess the current effectiveness of tourniquet placement in both a rural and urban trauma center
  • COVID-19 Case Series: Case series of early outcomes with utilization of tissue plasminogen activator to combat COVID-19 associated respiratory distress syndrome
  • VIRUS (international COVID study): Study site for the Society of Critical Care Medicine viral infection and respiratory illness universal study (VIRUS): COVDI-19 registry and validation of critical care data dictionary

Trauma, Surgery and Critical Care Research Publications 2017–2020

  1. MT Fitzgerald, DW Ashley, H Abudkhdeir, DB Christie III Rib Fracture Fixation in the 65 Years and Older Population: A Paradigm Shift in Management Strategy at a Level I Trauma Center J Trauma Acute Care Surg.
    March 2017;82(3):524-527
  2. LX Webb The Impact of Negative Pressure Wound Therapy on Orthopaedic Infection. Orthop Clin North Am.
    April 2017;48(2):167-179
  3. CJ Jean-Louis, J Madison, B Smith, O Battles, P Dale The Pathologic Finding of Combined Lobular Carcinoma In Situ and Invasive Lobular Cancer May Indicate More than Just a High-Risk Marker Role of Lobular Carcinoma in Situ. Am Surg.
    May 2017;83:482-485
  4. HR Nolan, M Fitzgerald, B Howard, J Jarrard, D Vaughn The Trauma Time-Out: Evaluating the Effectiveness of Protocol-Based Information Dissemination in the Traumatically Injured Patient. J Trauma Nurs.
    May/June 2017;24(3):170-173
  5. HR Nolan, B Christie III Access Through Altruism: A Community-Based Free Outpatient Surgery Program for the Working Poor in the United States. J Perioper Pract.
    June 2017;27(6):141-143
  6. JG Vaughan, AB Cauthen, A Allen, P Dale Evaluation of Cardiopulmonary Complication Rates after Port Insertion: Is a Postoperative X-Ray Needed? Am Surg.
    July 2017;7:778-779
  7. DW Ashley, EE Pracht, RS Medeiros, EV Atkins, EG Nesmith, TJ Johns, JR Dunne, JM Nicholas A Decade Evaluation of a State Trauma System: Has Access to Inpatient Trauma Care at Designated Trauma Centers Improved? Am Surg.
    July 2017;83(7):769-777
  8. D Lawrence, L Weigel, P Dale, MD Honaker Presenting Stage in Colon Cancer is Associated with Insurance Status. AM Surg.
    July 2017;83(7):728-732
  9. CE Fancher, A Scott, A Allen, P Dale Mammographic Screening at Age 40-45? What Difference Does It Make? The Potential Impact of American Cancer Society Mammography Screening Guideline. Am Surg.
    August 2017;83(8):847-849
  10. A Allen, A Cauthen, J Vaughan, P Dale The Clinical Utility and Cost of Postoperative Mammography Completed within One Year of Breast Conserving Therapy: Is It Worth It? Am Surg.
    August 2017;83(8):871-874
  11. M Griffin, B Howard, S Devictor, J Ferenczy, F Cobb, DB Christie The Impact of Hemodynamic Transesophageal Echocardiography on the Use of continuous Renal Replacement Therapy in Trauma. Am Surg.
    August 2017;83(8):855-859
  12. AS Wallace, V Tchatalbachev, J Nelson, Z Wang, P Dale, GB Biedermann Long Term Radiographic Findings of Breast Brachytherapy: Implications of Surgical Volume. J Oncology.
    August 2017;116(2):203-207
  13. DW Ashley, RF Mullins, CJ Dente, L Garlow, RS Medeiros, EV Atkins, G Solomon, D Abston, CH Ferdinand What Are the Costs of Trauma Center Readiness? Defining and Standardizing Readiness Costs for Trauma Centers Statewide. Am Surg.
    September 2017;83(9):979-990
  14. DW Ashley, JM Nicholas, CJ Dente, TJ Johns, LE Garlow, G Solomon, D Abston, CH Ferdinand Successful Incorporation of Performance Based Payments for Trauma Center Readiness Costs into the Georgia Trauma System. Am Surg.
    September 2017;83(9):966-971
  15. RL Lassiter, DW Ashley, RS Medeiros, BL Adam, EG NeSmith, TJ Johns, EV Atkins, CJ Dente, CH Ferdinand Descriptive Analysis of Venous Thromboembolism in Georgia Trauma Centers Compared with National Trauma Center Participating in the Trauma Quality Improvement Program. Am Surg.
    November 2017;83(11):1283-1288
  16. AS Wallace, JP Nelson, Z Wang, PS Dale, GB Biedermann In Support of the Choosing Wisely Campaign: Perceived Higher Risk Leads to Unnecessary Imaging in Accelerated Partial Breast Irradiation? Breast J.
    January 2018;24(1):12-15
  17. HR Nolan, DW Ashley, NA Stokes, DB Christie III Increasing Incidence of All-Terrain Vehicle Trauma Admissions in the Pediatric and Adult Populations: An Evaluation of Injury Types and Severity. Int J Orthop Trauma Nurs.
    February 2018;28:33-36
  18. MT Fitzgerald, DW Ashley, H Abukdeir, DB Christie III Chest Wall Stabilization Leads to Shortened Chest Tube Stay Time in Rib Fracture Patients After Traumatic Chest Wall Injury. Am Surg.
    May 2018;84(5):680-683
  19. DW Ashley, JL Wood, JD Colquitt, R Vaithi Impact of Trauma Volume on Emergency Department Throughput, as Seen by CT Scan Completion Times. Am Surg.
    July 2018;84(7):e225-227
  20. A Hadadi, P Dale, C Fancher, B Lian The Treatment of Triple Negative Breast Cancer: Does Insurance Status Matter? Am Surg.
    July 2018;84:e259-261
  21. Allen A, Cauthen A, Ashley DW Obstructive Uropathy Secondary to an Indirect Extraperitoneal Ureteral Inguinal Hernia. Am Surg.
    July 2018;84(7):e225-e227
  22. K Rhoades, B Smith, MD Honaker Neoadjuvant Capecitabine Results in Similar Total Lymph Node Harvests as 5-Fluorouracil but an Increased Number of Lymph Nodes Containing Adenocarcinoma on Resection. Am Surg.
    July 2018;84(7):e222-e224
  23. AM Scott, MC Callier, M Lashley, DA Cole, PS Dale A 12-Year Single-Institution Experience with Accelerated Partial Breast Irradiation. Am Surg.
    August 2018;84:1261-1263
  24. A Drahos, T Nowack, M Fitzgerald, DB Christie Long-term Postoperative Hardware Complications after Open Rib Fixation. Am Surg.
    August 2018;84(8):e317-319
  25. RJ Winchell, BJ Eastridge, MM Moore, DW Ashley, et al Developing a National Trauma system: Proposed Governance and Essential Elements. J Trauma Acute Care Surg.
    September 2018;85(3):637-341
  26. DW Ashley, EE Pracht, LE Garlow, RS Medeiros, EV Atkins, TJ Johns, et al Evaluation of the Georgia Trauma System Using the American College of Surgeons Needs Based Assessment of Trauma Systems Tool. Trauma Surg Acute Care Open.
    October 2018;3:e000188
  27. AA Aakriti, B Nguyen, T Le, B Lian, LX Webb, HV Vo Using 2D Gait Motion Analysis to Evaluate the Mercer Universal Prosthetic Device in a Vietnamese Population. Harvard Medical Student Review.
    Issue4/October 2018
  28. HR Nolan, BE Smith, MD Honaker Operative Time and Length of Stay is Similar Between Robotic Assisted and Laparoscopic Colon and Rectal Resections. J Robot Surg.
    December 2018;12(4):659-664
  29. A Allen, A Cauthen, P Dale, C Jean-Louis, A Lord, B Smith Evaluating the Frequency of Upgrade to Malignancy Following Surgical Excision of High-Risk Breast Lesions and Ductal Carcinoma in Situ Identified by Core Needle Biopsy. Breast J.
    January 2019;25:103-106
  30. Z Wang, DW Ashley, L Kong, J Kang, DK Nakayama, PS Dale Nuclear Factor-kB is Activated in Filter-Implanted Vena Cava. Cardiovasc Intervent Radiol.
    April 2019;42(4):601-607
  31. DB Christie 3rd, T Nowack, A Drahos, DW Ashley Geriatric chest wall injury: is it time for a new sense of urgency? J Thorac Dis.
    May 2019;11(Suppl 8):S1029-S1033
  32. DW Ashley, A Drahos, MT Fitzgerald, DB Christie 3rd Chest wall stabilization and rib plating in a 15-year old male adolescent after blunt thoracic trauma. J Thorac Dis.
    May 2019;11(Suppl 8):S1100-S1102
  33. A Drahos, MT Fitzgerald, DW Ashley, DB Christie 3rd Chest wall stabilization with rib plating after cardiopulmonary resuscitation. J Thorac Dis.
    May 2019;11(Suppl 8):S1103-S1105
  34. DW Ashley, RF Mullins, CJ Dente, TJ Johns, LE Garlow, RS Medeiros, EV Atkins, G Solomon, D Abston, CH Ferdinand How Much Green Does It Take to Go Orange? Determining the Cost Associated with Trauma Center Readiness. Journal of Trauma and Acute Care Surgery.
    May 2019;86(5):765-773
  35. LE Wells, B Smith, MD Honaker Rate of Conversion to an Open Procedure is Reduced in Patients Undergoing Robotic Colorectal Surgery: A Single-Institution Experience. J Minim Access Surg.
    July 2019;31339114
  36. T Nowack, DB Christie 3rd Ultrasound in trauma resuscitation and critical care with hTEE guidance. J Trauma Acute Care Surg.
    July 2019;87(1):234-239
  37. LC Bridges, AB Christie, HH Awad, EJ Sigman, DB Christie, RJ Ackermann Geriatric Trauma Screening Tool: Preinjury Functional Status Dictates Intensive Care Unit Discharge Disposition. Am Surg.
    August 2019;85(8):800-805
  38. AM Scott, MG Lashley, NB Drury, PS Dale Comparison of Call-Back Rates Between Digital Mammography and Digital Breast Tomosynthesis. Am Surg.
    August 2019;85(8):855-857
  39. RW Colbrunn, JE Dumpe, TF Nagle, JD Kolmodin, WK Barsoum, OM Saluan Robotically Simulated Pivot Shift That Represents the Clinical Exam. J Orthop Res.
    December 2019;37(12):2601-2608
  40. A Sapp, M Lashley, A Christie, DB Christie The Impact of Hemodynamic Transesophageal Echocardiography on Acute Kidney Injury Management and Use of Continuous Renal Replacement Therapy in Trauma. Am Surg.
    2019. In press
  41. AL Drahos, AM Scott, DW Ashley Multimodal Analgesia and Decreased Opioid Use in Adult Trauma Patients. Am Surg. Accepted
  42. J Ferenczy, H Nemec, M Ayoub Traumatic Evisceration and Incarceration of Small Bowel Through Vaginal Cuff: A Rare Surgical Emergency. Am Surg. Accepted
  43. H Nemec, H Atalah, M Kling, L Nichols, B Powers, DW Ashley Does Human Amnion Membrane Prevent Post-Operative Abdominal Adhesions? Am Surg. Accepted
  44. L Bridges, MD Honaker, BE Smith, A Montgomery Insurance Status in Rectal Cancer is Associated with Age at Diagnosis and May Be Associated with Overall Survival. Am Surg. Accepted
  45. A Scott, A Powell, A Drahos, L Bridges, M Honaker Management Strategies for Rectal Prolapse. Am Surg. Accepted
  46. C Lee, M Honaker Presacral Mass with Isolated Colon Adenocarcinoma. Am Surg. Accepted
  47. T Nowack, C Nonnemacher, DB Christie Video-Assisted Thoracoscopic Surgery as an Adjunct to Rib Fixation. Am Surg. Accepted
  48. E Forney, N Stokes, D Ashley, An Montgomery, DB Christie III A Review of Pre-Hospital Intubations by EMS After Transition of Medical Directors. Am Surg. Accepted
  49. W Wallace, DB Christie III Bilateral Chylothoraces After Blunt Trauma: A Report of a Case and Discussion of Conservative and Operative Management Strategies. Am Surg. Accepted
  50. A Scott, P Dale, A. Conforti, J. Gibbs Gene Expression Profile and Clinical Decision Making in the Treatment of Melanoma. Am Surg. Accepted
  51. H Nemec, A Smith, DB Christie III Largest Gist to Date: A Case Report. Am Surg. Accepted
  52. H Nemec, DB Christie, A Montgomery, D Vaughn The Wittmann Patch: Superior Closure for the Open Abdomen. Am Surg. Accepted
  53. A Sapp, D Vaughn, DB Christie Transdiaphragmatic Intercostal Hernia After Trauma: A Case Report, Literature Review, and Discussion of a Challenging Clinical Scenario. Am Surg. Accepted
  54. C Jean-Louis, R Parel, C Brown Treatment & Management of Abdominal Impalement Injury. Am Surg. Accepted
  55. DB Christie, HM Nemec, AM Scott, JT Buchanan, CM Franklin, A Ahmed, MS Khan, CW Callender, EA James, AB Christie, DW Ashley Early Outcomes with Utilization of Tissue Plasminogen Activator in COVID-19 Associated Respiratory Distress: A Series of Five Cases. J Trauma and Acute Care Surg. Accepted