Role 2 military hospitals: results of a new trauma care concept on 170 casualties

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• 作者：A. 脺nl眉 (1)
  R. A. Cetinkaya (2) (3)
  T. Ege (4)
  P. Ozmen (5)
  V. Hurmeric (6)
  M. T. Ozer (1)
  P. Petrone (7)
  
  1. Department of General Surgery ; GATA Military Medical Academy ; Ankara ; Turkey
  2. Department of Blood Banking ; GATA Military Medical Academy ; Ankara ; Turkey
  3. Department of Infectious Disease ; GATA Military Medical Academy ; Ankara ; Turkey
  4. Department of Orthopedic Surgery ; GATA Military Medical Academy ; Ankara ; Turkey
  5. Department of Military Health Service ; GATA Military Medical Academy ; Ankara ; Turkey
  6. Ophthalmology ; Dunya Goz Hastanesi ; Ankara ; Turkey
  7. Division of Trauma Surgery ; Surgical Critical Care and Acute Care Surgery ; Department of Surgery New York Medical College ; Westchester Medical Center University Hospital ; 100 Woods Road ; Taylor Pavilion - Suite E-140 ; Valhalla ; NY ; 10595 ; USA
  
• 关键词：Military hospitals ; Trauma ; Explosives and firearms injuries ; Outcomes
• 刊名：European Journal of Trauma and Emergency Surgery
• 出版年：2015
• 出版时间：April 2015
• 年：2015
• 卷：41
• 期：2
• 页码：149-155
• 全文大小：223 KB
• 参考文献：1. Champion, HR, Holcomb, JB, Lawnick, MM, Kelliher, T, Spott, MA, Galarneau, MR (2010) Improved characterization of combat injury. J Trauma. 68: pp. 1139-1150 CrossRef
  2. Moore, EE, Malangoni, MA, Cogbill, TH, Peterson, NE, Champion, HR, Jurkovich, GJ (1996) Organ injury scaling VII: cervical vascular, peripheral vascular, adrenal, penis, testis, and scrotum. J Trauma. 41: pp. 523-524 CrossRef
  3. Crabtree, TG (2006) Scope of wounds. J Am Acad Orthop Surg. 14: pp. S75-S76
  4. Weil, YA, Mosheiff, R, Liebergall, M (2006) Blast and penetrating fragment injuries to the extremities. J Am Acad Orthop Surg. 14: pp. S136-S139
  5. Bowyer, GW, Cooper, GJ, Rice, P (1995) Management of small fragment wounds in war: current research. Ann R Coll Surg Engl. 77: pp. 131-134
  6. Bowyer, GW (1996) Management of small fragment wounds: experience from the Afghan border. J Trauma 40: pp. S170-S172 CrossRef
  7. Zouris JM, Walker GJ, Dye J, Galarneau M. Wounding patterns for U.S. marines and sailors during Operation Iraqi Freedom, major combat phase. Mil Med. 2006;171:246鈥?2.
  8. Hamdan, TA (2006) Missile injuries of the limbs: an Iraqi perspective. J Am Acad Orthop Surg. 14: pp. S32-S36
  9. Cho, JM, Jatoi, I, Alarcon, AS, Morton, TM, King, BT, Hermann, JM (2005) Operation Iraqi Freedom: surgical experience of the 212th Mobile Army Surgical Hospital. Mil Med. 170: pp. 268-272
  10. Owens, BD, Wenke, JC (2007) Early wound irrigation improves the ability to remove bacteria. J Bone Joint Surg Am. 89: pp. 1723-1726 CrossRef
  11. Murray, CK, Hsu, JR, Solomkin, JS, Keeling, JJ, Andersen, RC, Ficke, JR (2008) Prevention and management of infections associated with combat-related extremity injuries. J Trauma 64: pp. S239-S251 CrossRef
  12. Sobaci, G, Akin, T, Mutlu, FM, Karagul, S, Bayraktar, MZ (2005) Terror-related open globe injuries: a 10-year review. Am J Ophthalmol. 139: pp. 937-939 CrossRef
  13. Erdurman, FC, Hurmeric, V, Gokce, G, Durukan, AH, Sobaci, G, Altinsoy, HI (2011) Ocular injuries from improvised explosive devices. Eye. 25: pp. 1491-1498 CrossRef
  14. Amato, JJ, Billy, LJ, Gruber, RP, Lawson, NS, Arsenal, E (1970) Vascualr injuries. An experimental study of high and low velocity missile wounds. Arch Surg. 101: pp. 167-174 CrossRef
  15. Phonsombat, S, Master, VA, McAninch, JW (2008) Penetratin external genital trauma: a 30-year single institution experience. J Urol. 180: pp. 192-195 CrossRef
  
• 刊物主题：Traumatic Surgery; Surgical Orthopedics; Emergency Medicine; Sports Medicine; Intensive / Critical Care Medicine; Surgery;
• 出版者：Springer Berlin Heidelberg
• ISSN：1863-9941

文摘

Introduction In recent military conflicts, military surgeons encounter more high-energy injuries associated with explosives. Advances in the field care and shorter evacuation time increased survival. However, casualties still incur severe injuries especially to the extremities. We present wound patterns, anatomical distribution and severity of injuries in a Role 2 hospital. Materials and methods Two years data have been retrospectively reviewed. Only explosives and firearms injuries were included in the study. Patient profile, admission details, mechanism of injury, AIS anatomical locations, ISS, surgical and medical treatments have been analyzed. Results Data revealed 170 male casualties. IEDs and GSW accounted for 133 (78聽%) and 37 (22聽%) casualties, respectively. An average of 1.8 IED and 1.2 GSW anatomical locations were exposed to injuries. Regardless of the mechanism, injuries were most commonly located in the extremities. IEDs caused significantly higher soft tissue injuries. Discussion Explosives do not necessarily cause more severe injuries than firearms. However, fragments create multiple, complicated soft tissue injuries which constitute more than half of the injuries. Timely wound debridement and excision of contaminated tissue are crucial to manage extremity soft tissue injuries. Conclusion Casualty care should be assessed within the context of the capabilities present at a hospital and the cause, type and severity of the wounds. The NATO description of Role 2 care only requires an integrated surgical team for damage control surgery with limited diagnostic and infrastructural capabilities.