Acute bilateral leg amputation following combat injury in UK servicemen

Penn-Barwell, Jowan G.; Bennett, Philippa M.; Fries, C. Anton; Cooper, J.; Kendrew, J.M.; Midwinter, Mark; Rickard, Rory F.; Sargeant, I.D.; Porter, Keith; Rowlands, T K; Mountain, Andrew; Kay, Alan; Jeffrey, S; Evirviades, D.; Cubison, Tania

doi:10.1016/j.injury.2014.01.025

Cited by 32 publications

(24 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…27 United Kingdom military personnel were also greatly impacted by this injury pattern with 2.8% of combat casualties sustaining bilateral lower limb amputations over a six-year period. 11 Due to the severity of these injuries, patients generally required large-volume blood transfusions (>10 units), debridements, and further surgical procedures in response to complications, such as infections. 11,27,28 One example was the unexpected surge in invasive fungal wound infections among military personnel who sustained blast injuries in Afghanistan.…”

Section: Discussionmentioning

confidence: 99%

“…11 Due to the severity of these injuries, patients generally required large-volume blood transfusions (>10 units), debridements, and further surgical procedures in response to complications, such as infections. 11,27,28 One example was the unexpected surge in invasive fungal wound infections among military personnel who sustained blast injuries in Afghanistan. Specifically, nearly 7% of the combat casualties admitted to LRMC between June 2009 and August 2011 were diagnosed with an invasive fungal wound infection.…”

Section: Discussionmentioning

confidence: 99%

“…8 These military operations saw changes in the patterns and severity of combat-related injuries, primarily due to the expanded utilization of improvised explosive devices (IEDs). 2–4,9–11 Accordingly, combat care evolved through advancements in preventive measures and treatments, along with the implementation of the Joint Theater Trauma System (JTTS) in November 2004. 12,13 In part due to the integrated approach to combat care executed by the JTTS, which emulates successful civilian trauma systems, the overall mortality rate of military personnel decreased during the conflicts in Iraq and Afghanistan (8.8%) when compared to World War II and Vietnam (22.8% and 16.5%, respectively).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Impact of Operational Theater on Combat and Noncombat Trauma-Related Infections

Tribble

Warkentien

et al. 2016

Military Medicine

View full text Add to dashboard Cite

The Trauma Infectious Disease Outcomes Study began in June 2009 as combat operations were decreasing in Iraq and increasing in Afghanistan. Our analysis examines the rate of infections of wounded U.S military personnel from operational theaters in Iraq and Afghanistan admitted to Landstuhl Regional Medical Center between June 2009 and December 2013 and transferred to a participating U.S. hospital. Infection risk factors were examined in a multivariate logistic regression analysis (expressed as odds ratios [OR]; 95% confidence intervals [CI]). The study population includes 524 wounded military personnel from Iraq and 4766 from Afghanistan. The proportion of patients with at least one infection was 28% and 34% from the Iraq and Afghanistan theaters, respectively. The incidence density rate was 2.0 (per 100 person-days) for Iraq and 2.7 infections for Afghanistan. Independent risk factors included large-volume blood product transfusions (OR: 10.68; CI: 6.73–16.95), high injury severity score (OR: 2.48; CI: 1.81–3.41), and improvised explosive device injury mechanism (OR: 1.84; CI: 1.35–2.49). Operational theater (OR: 1.32; CI: 0.87–1.99) was not a risk factor. The difference in infection rates between operational theaters is primarily due to increased injury severity in Afghanistan from a higher proportion of blast-related trauma during the study period.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of Operational Theater on Combat and Noncombat Trauma-Related Infections

Tribble

Warkentien

et al. 2016

Military Medicine

View full text Add to dashboard Cite

show abstract

“…6 paradigm shifts The advent of triage by Dominique Larrey under Napoleon Bonaparte was a major shift in war surgery and medicine that improved survival. 11 Meticulous inspection and debridement of devitalized tissues are essential in conjunction with arrest of haemorrhage from small or large vessels. As high-intensity blasts have become a significant mechanism of injury there has been a large increase in the amount of soft tissue disruption, especially in the limbs.…”

Section: The Principles Of War Surgerymentioning

confidence: 99%

“…11,12,[25][26][27] The aim in any complex wound from war is to achieve debridement with maximal tissue preservation, fracture fixation and wound control with dressings. All patients should be managed with a trauma principles approach,.…”

Section: The Military Plastic Surgeonmentioning

confidence: 99%