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War wound surgery

Patrick Hérard, François Boillot, Rasheed M Fakhri
PURPOSE: Hidden infections in a reconstructive surgery program are frequently underestimated. METHODS: A retrospective study was undertaken of 1,891 civilian war-wounded patients from Iraq, Syria, Yemen and Gaza treated in Amman from August 2006 to January 2016. One thousand three hundred and fifty-three underwent surgical interventions for previous bone injury and had systematic bone cultures. RESULTS: Among patients (167) without any clinical, biological or radiological signs of infection, 46% demonstrated infection based on bone cultures...
January 18, 2017: International Orthopaedics
Altuğ Duramaz, Mustafa Gökhan Bilgili, Berhan Bayram, Nezih Ziroğlu, Alkan Bayrak, Mustafa Cevdet Avkan
PURPOSE: The aim of this study was to evaluate the musculoskeletal injury types, injury mechanisms, surgical techniques and treatment costs of Syrian refugees. METHODS: Totally 158 patients (67 female, 91 male) treated in our clinic in 34 months period between January 2012 and October 2014 were included in the study. The mean age of the patients was 39.3 years (range: 18-82 years). The patients were evaluated for age, gender, mechanism of injury, location and type of fracture, presence of accompanying injuries, injury severity score, surgical technique, complications, mortality/morbidity and treatment cost...
January 7, 2017: International Orthopaedics
H Rode, C Brink, K Bester, M P Coleman, T Baisey, R Martinez
BACKGROUND: Burn injuries are common in poverty-stricken countries. The majority of patients with large and complex burns are referred to burn centres. Of the children who qualify for admission, according to burn admission criteria, about half require some kind of surgical procedure to obtain skin cover. These range from massive full-thickness fire burns to skin grafts for small, residual unhealed wounds. Burn anaesthetic procedures are of the most difficult to perform and are known for high complication rates...
November 2, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Camille Choufani, Olivier Aoun, Amélie Mlynski, Guillaume Boddaert, Xavier de Kerangal, Charles Pierret
INTRODUCTION: Injuries to the innominate artery are rare, but potentially fatal. Early diagnosis and treatment may avoid life-threatening complications. Endovascular surgery often has lower morbidity and mortality rates than conventional surgery. CLINICAL CASE: We reported the case of a 28-year-old Yemenite soldier who presented with a shrapnel-related chest puncture wound following a shell explosion in Djibouti causing a 5 mm pseudoaneurysm of the innominate artery without associated complications...
November 9, 2016: Acta Chirurgica Belgica
Ian L Valerio, Jennifer M Sabino, Christopher L Dearth
Background: A large volume of service members have sustained complex injuries during Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF). These injuries are complicated by contamination with particulate and foreign materials, have high rates of bacterial and/or fungal infections, are often composite-type defects with massive soft tissue wounds, and usually have multisystem involvement. While traditional treatment modalities remain a mainstay for optimal wound care, traditional reconstruction approaches alone may be inadequate to fully address the scope and magnitude of such massive complex wounds...
September 1, 2016: Advances in Wound Care
Jennifer M Sabino, Julia Slater, Ian L Valerio
Scope and Significance: Reconstruction of traumatic injuries requiring tissue transfer begins with aggressive resuscitation and stabilization. Systematic advances in acute casualty care at the point of injury have improved survival and allowed for increasingly complex treatment before definitive reconstruction at tertiary medical facilities outside the combat zone. As a result, the complexity of the limb salvage algorithm has increased over 14 years of combat activities in Iraq and Afghanistan. Problem: Severe poly-extremity trauma in combat casualties has led to a large number of extremity salvage cases...
September 1, 2016: Advances in Wound Care
Ali Ebrahimi, Nasrin Nejadsarvari, Hamid Reza Rasouli, Azin Ebrahimi
BACKGROUND: Anterior cranial bone defects secondary to global war cranial defects pose a unique reconstructive challenge. The objective of this study was to evaluate the outcomes of alloplastic reconstructions of cranial bone with titanium mesh and fat graft after warfare-related cranial trauma. PATIENTS AND METHODS: Thirty-five patients at the plastic and reconstructive surgery ward of our hospital underwent anterior cranioplasty with titanium mesh with or without fat grafts from lower abdominal wall...
January 2016: Annals of Maxillofacial Surgery
Y H Sun
Burn is a common trauma in peace time and war. Burn care was not designated as a specific discipline but a subspecialty of general surgery in China until the 1950s. In 1958, along with the development of metallurgical industry in China, the number of burn patients was increased remarkably, followed by establishment of modern burn departments. A steel worker sustaining a burn injury with size of 89% total burn surface area (TBSA) and full-thickness wound size of 23% TBSA was successfully cured by burn experts of Shanghai Guangci Hospital (renamed Ruijin Hospital Affiliated to the School of Medicine of Shanghai Jiao Tong University)...
January 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
Sandeep Mehrotra, Manish Mehrotra
Regional block anaesthesia (RBA) techniques are eclipsed by the widespread use of general anaesthesia (GA), especially in trauma surgery. This is despite the numerous advantages that regional blocks have to offer. We conducted a study to evaluate efficacy, safety and feasibility of RBA in isolated extremity trauma in war scenario. A prospective study was carried out over a period of eight months. There were a total of 96 patients with splinter, mine blast and gun shot wounds. Supraclavicular or axillary brachial block was employed for upper extremity surgery...
July 2002: Medical Journal, Armed Forces India
Hatice Kaya Ozdogan, Faruk Karateke, Mehmet Ozdogan, Sibel Cetinalp, Sefa Ozyazici, Yurdal Gezercan, Ali Ihsan Okten, Muge Celik, Salim Satar
OBJECTIVE: Since the civilian war in Syria began, thousands of seriously injured trauma patients from Syria were brought to Turkey for emergency operations and/or postoperative intensive care. The aim of this study was to present the demographics and clinical features of the wounded patients in Syrian civil war admitted to the surgical intensive care units in a tertiary care centre. METHODS: The records of 80 trauma patients admitted to the Anaesthesia, General Surgery and Neurosurgery ICUs between June 1, 2012 and July 15, 2014 were included in the study...
May 2016: Pakistan Journal of Medical Sciences Quarterly
M Uzair Ilyas Tahirkheli, Irfan Ellahi, Muhammad Farooq Dar, Arslan Sharif
OBJECTIVE: To determine the effect of mechanism of injury on wound healing, and on the viability and success of distally based sural flap when used for the coverage of defects of lower leg, ankle and foot. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Department of Surgery, Combined Military Hospital, Peshawar and Khariyan, from January 2012 to December 2014. METHODOLOGY: Patients with soft tissue defects over the distal leg, ankle and foot were selected by purposive sampling technique and divided into 2 groups of 19 patients each...
May 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Laura Maitland, Graham Lawton, James Baden, Tania Cubison, Rory Rickard, Alan Kay, Shehan Hettiaratchy
BACKGROUND: Plastic surgery has historically been linked to war. Between 2008 and the end of combat operations in Afghanistan in 2014, British military plastic surgeons formed part of the multinational military surgical team at the Role 3 Medical Treatment Facility, Camp Bastion, Helmand Province. The present study aimed to analyze the activity of these surgeons objectively and to determine the utility of their deployment. METHODS: Data were gathered prospectively from four periods (2009 to 2012)...
April 2016: Plastic and Reconstructive Surgery
Michael S Baker
The maturation of vascular surgery into widespread clinical practice was accelerated by events that took place in Korea during the conflict of 1950-1953. Early research and anecdotal clinical trials were just then resulting in publication of cases of the successful vascular repairs and replacements. Noncrushing vascular clamps were being developed and limited manufacture begun. The stage was set for a major advance in the treatment of arterial injury, just as war commenced in Korea, which provided a clinical laboratory...
May 2016: Annals of Vascular Surgery
L Riddez
INTRODUCTION: Terror attacks with explosive devices or mass shootings have introduced a new pattern of injuries into the civilian sector. The aim of this short review on the treatment principles for so-called penetrating war wounds is to remind surgeons who are not normally confronted with them of some basic rules to follow and pitfalls to avoid. MATERIALS AND METHODS: This review article is based on literature research of the National Library of Medicine and the National Institutes of Health MEDLINE database using PubMed, as well as updated books on war surgery and the author's own experience of war zones...
August 2014: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Åsa Edsander-Nord
OBJECTIVES: To illustrate the character, clinical course and late complications of wounds caused by high energy with severe contamination during a natural disaster, as a basis for designing principles for primary treatment under these conditions. PATIENTS AND METHODS: This paper presents case reports from complicated wounds treated at a specialized unit for wound management in a hospital receiving patients after transfer from primary to definitive treatment. RESULTS: Of the Swedish citizens evacuated from the disaster zone in Thailand after the tsunami disaster in 2004, 174 of those arriving at Stockholm Airport were referred to the Karolinska Hospital for treatment, of whom 75 were admitted...
October 2008: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Miguel Trelles, Lynette Dominguez, Katie Tayler-Smith, Katrin Kisswani, Alberto Zerboni, Thierry Vandenborre, Silvia Dallatomasina, Alaa Rahmoun, Marie-Christine Ferir
BACKGROUND: Since 2011, civil war has crippled Syria leaving much of the population without access to healthcare. Various field hospitals have been clandestinely set up to provide basic healthcare but few have been able to provide quality surgical care. In 2012, Medecins Sans Frontieres (MSF) began providing surgical care in the Jabal al-Akrad region of north-western Syria. Based on the MSF experience, we describe, for the period 5th September 2012 to 1st January 2014: a) the volume and profile of surgical cases, b) the volume and type of anaesthetic and surgical procedures performed, and c) the intraoperative mortality rate...
2015: Conflict and Health
Jeffrey Gusky, Debbie Lancaster
No abstract text is available yet for this article.
2015: Pharos of Alpha Omega Alpha-Honor Medical Society
Peter M Formby, Scott C Wagner, Daniel G Kang, Gregory S Van Blarcum, Alfred J Pisano, Ronald A Lehman
BACKGROUND CONTEXT: The ideal timing of surgical decompression or stabilization following combat-related spine injury remains unclear. PURPOSE: The study aims to determine the etiology and factors related to reoperation following evacuation to the United States after undergoing in-theater spine surgery. STUDY DESIGN: This is a retrospective analysis. PATIENT SAMPLE: The sample includes 13 patients with combat-related spine injuries undergoing revision spine surgery...
March 2016: Spine Journal: Official Journal of the North American Spine Society
Colin Ng, Max Mifsud, Joseph N Borg, Colin Mizzi
AIM: The purpose of this series of cases was to analyse our management of orthopaedic trauma casualties in the Libyan civil war crisis in the European summer of 2014. We looked at both damage control orthopaedics and for case variety of war trauma at a civilian hospital. Due to our geographical proximity to Libya, Malta was the closest European tertiary referral centre. Having only one Level 1 trauma care hospital in our country, our Trauma and Orthopaedics department played a pivotal role in the management of Libyan battlefield injuries...
2015: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Nebojša Djenić, Milan Višnjić, Saša Dragović, Vladmila Bojanić, Zoran Bojanić, Dragan Djurdjević, Boris Djindjić, Miloš Kostov
BACKGROUND/AIM: Gunshot wounds caused by the automatic rifle M70AB2 (AK-47) 7.62 mm, after the primary surgical management, were closed with delayed primary suture during the next four to seven days. This period coincides with the fibroblastic phase of wound healing. Fibrin glue is used as a local hemostatic and as a matrix for the local dosed release of antibiotics. Antibiotics addition to fibrin glue resulted in continuous diffusion into the surrounding next 4 to 7 days. The aim of this study was to create the preconditions for gunshot wounds closing without complications by the application of fibrin glue with antibiotics 24 h after primary surgical treatment...
September 2015: Vojnosanitetski Pregled. Military-medical and Pharmaceutical Review
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