Amputation in emergency situations: indications, techniques and Médecins Sans Frontières France’s experience in Haiti

Purpose This is a descriptive analysis, of victims of Turkey's October 23, 2011 and November 21, 2011 Van earthquakes. The goal of this study is investigated the injury profile of the both earthquakes in relation to musculoskeletal trauma.Methods We retrospectively reviewed medical records of 3,965 patients admitted to in seven hospitals. A large share of these injuries were soft tissue injuries, followed by fractures, crush injuries, crush syndromes, nerve injuries, vascular injuries, compartment syndrome and joint dislocations. A total Conclusions The results of this study may provide the basis for future development of strategy to optimise attempts at rescue and plan treatment of survivors with musculoskeletal injuries after earthquakes.

Section: Discussionsupporting

confidence: 52%

Review of Van earthquakes form an orthopaedic perspective: a multicentre retrospective study

Güner

Işık

et al. 2012

“…This further surgical procedure exposes susceptible patients to the risk of operative surgical intervention and other serious complications [4,9]. Extremity amputation is a common life-saving procedure in the management of victims of natural disasters and mass casualties with severely injured limbs [5,6,14,19]. In natural disasters and mass casualties, a limited human and material resource is one of the challenges in providing medical care to the injured victims.…”

Section: Introductionmentioning

confidence: 99%

An analysis of risk factors associated with traumatic extremity amputation stump wound infection in a Nigerian setting

Omoke

Nwigwe

2012

Purpose We aimed to determine the risk factors associated with traumatic extremity amputation stump wound infection in our environment. Method This was a retrospective analysis of databases that included the entire patient population with traumatic extremity amputation seen in Ebonyi State University Teaching Hospital and Federal Medical Centre Abakaliki from January 2001 to December 2011. Result There were 63 patients studied and stump wound infection was a complication in 38 (60 %) of them. Stump wound infection rate significantly correlated with the form of amputation, i.e., a higher rate in crushing than guillotine (sharp clear-cut) amputation (80.5 vs. 22.7 % p<0.000); severity, i.e., a higher rate in major than minor amputation (80.6 vs. 33.3 % p<0.000); and limb involvement, i.e., a higher rate in lower than upper extremity amputation (71.1 vs. 60.7 % p<0.002). Haematocrit level on admission (p< 0.002), injury to hospital admission interval (p<0.012) and injury to first surgical debridement / amputation interval (p< 0.02) were all significantly related to incidence of wound infection. Multivariate analysis identified crushing amputation as an independent risk factor (p<0.009) for traumatic amputation stump wound infection. Conclusion The only independent predictor of traumatic extremity amputation stump wound infection is a crushing form of amputation; it should be accorded a high priority in interventions aimed at reducing infection rate

“…These presentations have been collected in this issue of International Orthopaedics, including the experience gathered from Haiti [1,2], the French Army [3], Pakistan [4], and the approach of Handicap International [5].…”

mentioning

confidence: 99%

SICOT contribution to natural disasters assistance

Hinsenkamp

2012

Among all human tragedies and injustices, specific circumstances such as natural disasters require an immediate worldwide mobilisation due to their rarity, the intensity of their damage and the human resources and logistics needed.SICOT, as the International Society of Orthopaedic Surgery and Traumatology, has the duty to participate in the coordination of such interventions. This is also a unique opportunity to test the international fraternity among the national representatives and the SICOT members.In the last seven years, the SICOT experience has been growing in this field. Following the earthquake in Pakistan in 2005, many SICOT members expressed their willingness to offer their services as orthopaedic surgeons and to provide medical assistance locally. SICOT, as a scientific association, does not have the logistics to organise such a medical intervention but provides an ideal international hub to direct medical forces, represented by the expertise and skill of its volunteering members, to humanitarian associations which have the professional experience to organise those missions.In the emergency situation in Muzafarabad in 2005, with the intervention of the National Delegate of Pakistan, Syed Awais, SICOT was able to facilitate the participation of the Cuban orthopaedic team sent by Rodrigo Alvarez Cambras, National Delegate of Cuba. However, more is needed to coordinate all the individual SICOT volunteers ready to provide surgical care on site should another disaster occur.In 2006, we started a collaboration with Médecins Sans Frontières (Doctors Without Borders) and received 84 replies from SICOT members volunteering for emergency missions in the event of a natural disaster with mass casualties. In 2008, this volunteer group was provided with specific practical information to facilitate the emergency call up. A briefing session for European volunteers took place in Brussels to prepare future missions and provide them with relevant information on the equipment available and the practical conditions of an intervention. In addition, a CD produced by MSF was circulated to all volunteers with very comprehensive guidelines on emergencies, war surgery, mass casualty triage, and land mine injuries.In April 2008, the first concrete achievement of this collaboration was the delivery of essential drugs and basic necessities by MSF to the war-torn area of Basra, thanks to our National Delegate of Iraq, Thamer Hamdan.After the earthquake in Haiti, 16 SICOT volunteers from the existing list answered almost immediately to our appeal for help. Among them, two were enrolled in the MSF team according to their availability: Nanjundappa S. Harshavardhana and Kuldeep Sain. They have reported on their experiences in the SICOT Newsletter. SICOT's immediate action just after the earthquake was greatly appreciated by the MSF team. We had been well prepared since 2005 and our participation proved to be very efficient, even though only a small number took part.A review of the Haiti earthquake experience was presented during a symp...