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Battlefield surgery

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https://www.readbyqxmd.com/read/29604210/a-new-triage-method-for-burn-disasters-fast-triage-in-burns-ftb
#1
Agnieszka Surowiecka-Pastewka, Wojciech Witkowski, Marek Kawecki
BACKGROUND There are few triage methods based on patient age and extent of burn. However, in case of mass casualties, age might be hard to define. Burn segregation in mass-casualty accidents requires an easy, fast, and effective method. Triage in burns should also segregate casualties requiring treatment in burn centers. The aim of this study was to create a proprietary segregation algorithm dedicated to mass-casualty incidents. MATERIAL AND METHODS A retrospective analysis of 939 burned patients admitted to the Clinical Department of Burns, Plastic and Reconstructive Surgery, Military Institute of Medicine (MIM) in Warsaw and to the Center for the Treatment of Burns (CTB) in Siemianowice Śląskie in 2012 and 2013 was performed...
March 31, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29533448/prehospital-medicine-and-the-future-will-ecmo-ever-play-a-role
#2
David Macku, Pavel Hedvicak, John Quinn, Vladimir Bencko
Due to the hybrid warfare currently experienced by multiple NATO coalition and NATO partner nations, the tactical combat casualty care (TCCC) paradigm is greatly challenged. One of the major challenges to TCCC is the ad hoc extension phase in resource-poor environments, referred to as prolonged field care (PFC) and forward resuscitative care (FRC). The nuanced clinical skills with limited resources required by warfighters and auxiliary health care professionals to mitigate death on the battlefield and prevent morbidity and mortality in the PFC phase represent a balance that is still under review...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/29514345/military-trauma-and-surgical-procedures-in-conflict-area-a-review-for-the-utilization-of-forward-surgical-team
#3
Yi-Ling Cai, Jin-Tao Ju, Wen-Bao Liu, Jian Zhang
Introduction: Forward surgical teams (FSTs) have been used as highly mobile surgical facilities that provide "damage control" medical support in modern wars. FST regiments differ greatly in different armed services and nations. We systemically reviewed the utilization of FSTs around the world with an emphasis on the medical conditions and workloads encountered by FSTs in modern wars. Materials and Methods: We searched for terms related to FSTs, such as "Forward Surgical Team" and "Field Surgical Team," in the PubMed, EMBASE, Web of Science, and MEDLINE databases and collected any articles that provided numerical data on the organization of medical personnel combat casualty characteristics, including the casualty composition, injury types and locations, and mechanisms of injury, and surgical procedures performed...
March 1, 2018: Military Medicine
https://www.readbyqxmd.com/read/29490887/facial-restoration-by-transplantation
#4
REVIEW
Branislav Kollar, Bohdan Pomahac
Hundred years ago, Sir Harold Gillies laid a foundation to the modern plastic surgery trying to reconstruct facial defects of severely disfigured soldiers of World War I. Some years later, Joseph Murray experimented with rejection of skin grafts aimed for treatment of burned patients who sustained their injuries on battlefields of World War II. In 1954, the acquired expertise and intensive research allowed him to perform the first successful kidney transplantation in the world at Peter Bent Brigham Hospital in Boston...
February 25, 2018: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/29470190/blood-transfusion-management-in-the-severely-bleeding-military-patient
#5
Jennifer M Gurney, Philip C Spinella
PURPOSE OF REVIEW: Hemorrhage remains the primary cause of preventable death on the battlefield and in civilian trauma. Hemorrhage control is multifactorial and starts with point-of-injury care. Surgical hemorrhage control and time from injury to surgery is paramount; however, interventions in the prehospital environment and perioperative period affect outcomes. The purpose of this review is to understand concepts and strategies for successful management of the bleeding military patient...
April 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29425720/nanoengineered-injectable-hydrogels-for-wound-healing-application
#6
Giriraj Lokhande, James K Carrow, Teena Thakur, Janet R Xavier, Madasamy Parani, Kayla J Bayless, Akhilesh K Gaharwar
We report injectable nanoengineered hemostats for enhanced wound healing and tissue regeneration. The nanoengineered system consists of the natural polysaccharide, κ-carrageenan (κCA), loaded with synthetic two-dimensional (2D) nanosilicates. Nanoengineered hydrogels showed shear-thinning characteristics and can be injected for minimally invasive approaches. The injectable gels can be physically crosslinked in presence of monovalent ions to form mechanically strong hydrogels. By controlling the ratio between κCA and nanosilicates, compressive stiffness of crosslinked hydrogels can be modulated between 20 and 200 kPa...
April 1, 2018: Acta Biomaterialia
https://www.readbyqxmd.com/read/29218283/early-reconstructions-of-complex-lower-extremity-battlefield-soft-tissue-wounds
#7
Ali Ebrahimi, Nasrin Nejadsarvari, Azin Ebrahimi, Hamid Reza Rasouli
BACKGROUND: Severe lower extremity trauma as a devastating combat related injury is on the rise and this presents reconstructive surgeons with significant challenges to reach optimal cosmetic and functional outcomes. This study assessed early reconstructions of complex lower extremity battlefield soft tissue wounds. METHODS: This was a prospective case series study of battled field injured patients which was done in the Department of Plastic Surgery, Baqiyatallah University of Medical Sciences hospitals, Tehran, Iran between 2013-2015...
September 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28941569/wound-ballistics-and-blast-injuries
#8
N J Prat, J-L Daban, E J Voiglio, F Rongieras
Wounds due to gunshot and explosions, while usually observed during battlefield combat, are no longer an exceptional occurrence in civilian practice in France. The principles of wound ballistics are based on the interaction between the projectile and the human body as well as the transfer of energy from the projectile to tissues. The treatment of ballistic wounds relies on several principles: extremity wound debridement and absence of initial closure, complementary medical treatment, routine immobilization, revision surgery and secondary closure...
December 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/28941503/management-of-high-velocity-injuries-of-the-head-and-neck
#9
REVIEW
Jacob S Majors, Joseph Brennan, G Richard Holt
Trauma centers must prepare to manage high-velocity injuries resulting from a mass casualty incidents as global terrorism becomes a greater concern and an increasing risk. The most recent conflicts in Iraq and Afghanistan have significantly improved understanding of battlefield trauma and how to appropriately address these injures. This article applies combat surgery experience to civilian situations, outlines the physiology and kinetics of high-velocity injuries, and reviews applicable triage and management strategies...
November 2017: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/28876574/holding-the-torch-up-high-a-medical-historical-evaluation-of-surgical-advances-during-the-great-war-1914-1918-in-memory-of-those-that-served-and-fell
#10
G Scharf
"How wide and varied is the experience of the battlefield and how fertile the blood of warriors in raising good surgeons" Sir Clifford Allbutt (1898). With these sentiments of the medical lessons learned in war and conflict, with the background of the poem of "In Flanders Field", written by a doctor who had South African War connections, reasons (the Somme and third Ypres battles) will be given that this was indeed a "GREAT WAR" as the world history, weapons, strategy, tactics and wounding patterns had changed dramatically...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28828175/combination-of-dura-turning-over-and-decompressive-craniectomy-a-new-pattern-of-surgery-for-cerebral-infarction-caused-by-craniocerebral-gunshot-injury
#11
Qi-Yong Mei, Yao Li, Chao He, Hong-Wei Shan, Yun-Kun Wang, Yan Dong, Ming-Kun Yu, Li-Jun Hou
BACKGROUND: Craniocerebral gunshot injury refers to a wound caused by a bullet passing through or lodged in brain tissue, resulting in the loss of function of a certain area or other fatal damage to the human brain. Craniocerebral gunshot injury is usually life-threatening and is very common in modern warfare, accounting for the majority of battle casualties. Most of the patients suffer from acute cerebral infarction caused by vascular injury. Lack of early and solid battlefield emergency medical interference adds to the risk of death among the wounded...
2017: Military Medical Research
https://www.readbyqxmd.com/read/28748419/can-we-train-military-surgeons-in-a-civilian-trauma-center
#12
H Uchino, V Y Kong, G V Oosthuizen, J L Bruce, W Bekker, G L Laing, D L Clarke
INTRODUCTION: The objective of this study was to review the trauma workload and operative exposure in a major South African trauma center and provide a comparison with contemporary experience from major military conflict. MATERIALS AND METHODS: All patients admitted to the PMTS following trauma were identified from the HEMR. Basic demographic data including mechanism of injury and body region injured were reviewed. All operative procedures were categorized. The total operative volume was compared with those available from contemporary literature documenting experience from military conflict in Afghanistan...
January 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/28570213/the-university-of-toronto-s-lasting-contribution-to-war-surgery-how-maj-l-bruce-robertson-fundamentally-transformed-thinking-toward-blood-transfusion-during-the-first-world-war
#13
Abigail Tien, Andrew Beckett, Dylan Pannell
During the Great War, Canadian military surgeons produced some of the greatest innovations to improve survival on the battlefield. Arguably, the most important was bringing blood transfusion practice close to the edge of the battlefield to resuscitate the many casualties dying of hemorrhagic shock. Dr. L. Bruce Robertson of the Canadian Army Medical Corps was the pioneering surgeon from the University of Toronto who was able to demonstrate the benefit of blood transfusions near the front line and counter the belief that saline was the resuscitation fluid of choice in military medicine...
June 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28254598/management-of-war-related-ballistic-craniocerebral-injuries-in-a-french-role-3-hospital-during-the-afghan-campaign
#14
MULTICENTER STUDY
Arnaud Dagain, Olivier Aoun, Julien Bordes, Cédric Roqueplo, Christophe Joubert, Pierre Esnault, Aurore Sellier, Jean-Marc Delmas, Nicolas Desse, Mathilde Fouet, Philippe Pernot, Renaud Dulou
INTRODUCTION: France deployed to Afghanistan from 2001 to 2014 within the International Security and Assistance Force. A French role 3 hospital was built in 2009 in the vicinity of Kabul International Airport (KaIA). The objectives of this study were to describe the epidemiology, management, and outcome of war-related craniocerebral injuries during the Afghan campaign in a French role 3 hospital. METHODS: From March 1, 2010 to September 30, 2012, we conducted a retrospective descriptive study in Kabul, Afghanistan...
June 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28230629/point-of-injury-tourniquet-application-during-operation-protective-edge-what-do-we-learn
#15
Amir Shlaifer, Avraham Yitzhak, Erez N Baruch, Avi Shina, Alexandra Satanovsky, Amiram Shovali, Ofer Almog, Elon Glassberg
BACKGROUND: Hemorrhage is a leading cause of preventable death on the battlefield. Timely tourniquet application to massively bleeding extremity wounds is critical for casualty survival albeit with reported adverse effects to extremity integrity. The aim of this study was to describe the immediate- and short-term outcomes of point of injury (POI) tourniquet applications during "Operation Protective Edge" (OPE). METHODS: A case series study regarding tourniquet application at the POI during OPE was collected...
August 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28102530/surgeon-preparedness-for-mass-casualty-events-adapting-essential-military-surgical-lessons-for-the-home-front
#16
Kyle N Remick, Stacy Shackelford, John S Oh, Jason M Seery, Daniel Grabo, John Chovanes, Kirby R Gross, Shawn C Nessen, Nigel Rm Tai, Rory F Rickard, Eric Elster, C W Schwab
Military surgeons have gained familiarity and experience with mass casualty events (MCEs) as a matter of routine over the course of the last two conflicts in Afghanistan and Iraq. Over the same period of time, civilian surgeons have increasingly faced complex MCEs on the home front. Our objective is to summarize and adapt these combat surgery lessons to enhance civilian surgeon preparedness for complex MCEs on the home front. The authors describe the unique lessons learned from combat surgery over the course of the wars in Afghanistan and Iraq and adapt these lessons to enhance civilian surgical readiness for a MCE on the home front...
2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28040370/benefit-of-extracorporeal-membrane-oxygenation-in-major-burns-after-stun-grenade-explosion-experience-from-a-single-military-medical-center
#17
Po-Shun Hsu, Yi-Ting Tsai, Chih-Yuan Lin, Shyi-Gen Chen, Niann-Tzyy Dai, Cheng-Jung Chen, Jia-Lin Chen, Chien-Sung Tsai
INTRODUCTION: Explosion injury is very common on the battlefield and is associated with major burn and inhalation injuries and subsequent high mortality and morbidity rates. Here we report six victims who suffered from explosion injuries caused by stun grenade; all were treated with extracorporeal membrane oxygenation (ECMO) as salvage therapy. This study was aimed to evaluate the indications and efficacy of ECMO in acute and critically ill major burn patients. METHODS: This was a retrospective analysis of six patients from Tri-Service General Hospital, National Defense Medical Center in Taiwan...
May 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/27724088/advances-in-military-resuscitation
#18
Sharon Edwards, Jason Smith
Trauma is a leading cause of death and disability worldwide, in civilian environments and on the battlefield. Trauma-induced haemorrhage is the principal cause of potentially preventable death, which is generally attributable to a combination of vascular injury and coagulopathy. Survival rates following severe traumatic injury have increased due to advanced trauma management initiatives and treatment protocols, influenced by lessons learned from recent conflicts in Iraq and Afghanistan. The use of tourniquets and intraosseous needles, early blood and blood product transfusion, administration of tranexamic acid in pre-hospital settings, and consultant-led damage control resuscitation incorporating damage control surgery have all played their part...
October 6, 2016: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/27613217/grace-under-fire-the-army-nurses-of-pearl-harbor-1941
#19
Gwyneth R Milbrath
OBJECTIVE: Much has been written about the military events of December 7, 1941; however, little has been documented about the nurses' work and experience at Pearl Harbor, Hawaii. The aerial assault on Pearl Harbor was the first time in US history that Army nurses had been on the front line of battle. Nurses quickly triaged and stabilized those who could be saved, and provided compassion and comfort to those who were dying, in an environment where the nurses were unsure of their own survival...
October 2016: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/27318022/total-phallic-reconstruction-using-the-radial-artery-based-forearm-free-flap-after-traumatic-penile-amputation
#20
Marco Falcone, Giulio Garaffa, Amr Raheem, Nim A Christopher, David J Ralph
INTRODUCTION: Although genital injuries in civilian centers are rare, the scenario is completely different in the battlefield. If the penile distal stump is not adequate for primary reimplantation or it cannot be found, then delayed penile reconstruction needs to be considered. AIM: To report a single-center experience with total phallic reconstruction using radial artery based forearm free flap (RAFFF) after penile traumatic loss. METHODS: We retrospectively reviewed the clinical records of 10 patients who underwent total phallic reconstruction with the use of the RAFFF from September 2001 through August 2015 after traumatic amputation of the penis...
July 2016: Journal of Sexual Medicine
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